Systems and methods for enabling customers to obtain vision and eye health examinations

ABSTRACT

Systems and methods are provided for eye health and vision examinations. A customer diagnostic center is configured to generate customer examination data pertaining to an examination of a customer&#39;s eye. The customer diagnostic center provides a user interface for communicating with a customer and ophthalmic equipment for administering tests to the customer. A diagnostic center server is configured to receive the customer examination data from the customer diagnostic center over a network and allow the customer examination data to be accessed by an eye-care practitioner. A practitioner device associated with the eye-care practitioner is configured to receive the customer examination data from the diagnostic center server and display at least a portion of the customer examination data to the eye-care practitioner. Customer evaluation data is generated pertaining to the eye-care practitioner&#39;s evaluation of the customer examination data. An eye health report is provided to the customer via the network.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims benefit to and is a continuation of U.S. patentapplication Ser. No. 16/224,616 filed on Dec. 18, 2018, which is acontinuation of U.S. patent application Ser. No. 16/018,499 filed onJun. 26, 2018, which is a continuation of U.S. patent application Ser.No. 14/966,463 filed on Dec. 11, 2015 (now, U.S. Pat. No. 10,083,279),which is a continuation of U.S. application Ser. No. 14/073,812 filedNov. 6, 2013 (now, U.S. Pat. No. 9,230,062), which is acontinuation-in-part of PCT/US2013/038508 filed Apr. 26, 2013, whichclaims the benefit of U.S. Provisional Patent Application No. 61/723,188filed on Nov. 6, 2012. The contents of all the above-identifiedapplications are incorporated by reference herein in their entireties.

FIELD OF THE INVENTION

The present invention generally relates to the fields of optometry andophthalmology and the performance of eye examinations. Morespecifically, certain embodiments are directed to systems and methodsfor enabling customers and other users to obtain eye health examinationsand vision examinations through a customer diagnostic center thatincludes ophthalmic equipment and instruments for performing varioustests and procedures pertaining to the customers' eye health and visualability. According to certain of these embodiments, the customerdiagnostic center provides data pertaining to the customer and the teststo a remote practitioner via a network for review and evaluation andreceives an eye health report from the remote practitioner to beprovided to the customer.

BACKGROUND OF THE INVENTION

In today's age of increased awareness of health monitoring and theimportance of early detection and prevention of various medicalconditions, disorders and diseases, individuals are often required tomake visits to medical practitioners for a range of tests and check-ups.For example, it is generally recommended that individuals make regularvisits (e.g., once every year, two years, etc.) to practitioners inconnection with the monitoring, diagnosis, and treatment of medicalconditions in number of areas, such as checking heart-health, detectingvarious cancers, and monitoring for certain genetically predisposeddisorders.

One area in which there is a particular need for regular visits to amedical professional is in connection with the examination of anindividual's eyes. Typically, the examination of a person's eyesinvolves the performance of one or more tests for monitoring anddiagnosing eye health, such as detecting glaucoma and retinal disorders,inspecting the pupil, and measuring corneal sensitivity, and/or testsfor evaluating visual ability and acuity, such as determining refractiveerror and detecting color blindness.

There are a number of important benefits to obtaining eye healthexaminations and/or vision examinations on a regular and continualbasis. For example, as with many other types of medical examinations,regular visits and checkups by an individual enable practitioners tomonitor and track the health of the individual's eyes and to detect anddiagnose certain disorders, diseases and other changes in the patient'seyes and/or vision. Significantly, this allows for early detection,diagnosis and treatment of many conditions, which, in turn, frequentlyincreases the likelihood that the treatment will be successful. In fact,many disorders and diseases are generally treatable or even preventablewhen detected and diagnosed in the early stages. Also, it is well knownthat changes in vision can often occur somewhat suddenly, such as atcertain periods in a person's life, and eyesight can deterioratecontinually over time. Accordingly, another important benefit to regulareye examinations is that they help to ensure that optical prescriptionsfor individuals are up to date and as accurate as possible.

Given these and numerous other benefits associated with regular eyeexaminations, it is not surprising that many well-known optometric andophthalmologic associations and organizations typically recommend thatindividuals visit eye care professionals once every one or two yearsMoreover, the need to receive regular eye examinations is particularlyimportant for certain individuals, including those who have a higherlikelihood of suffering from various disorders and diseases based ontheir demographics or other characteristics, such as age, race,profession, individual and/or family history of diseases or disorders,etc. As a result, it is often recommended that many such individualsreceive eye exams at least once a year or on an even more frequentbasis.

Additionally, it is well known and widely accepted in the eye care andvision field that, in order to maximize these benefits, the regularexaminations received by individuals may be in the form of comprehensiveeye examinations. Typically, to be considered comprehensive, suchexaminations may include certain approved tests and procedures and/ormeet certain minimum standards and requirements for testing anddiagnosis. In particular, comprehensive eye examinations may includesome or all of the following tests and procedures (or tests andprocedures of an equivalent nature): (i) objective and subjectiverefraction and/or other tests to check visual acuity; (ii) examinationof the extraocular muscles; (iii) peripheral vision test (e.g., bychecking the visual field by confrontation); (iv) examination of theexternal eye; (v) examination of the pupils; (vi) color vision test;(vii) test for stereopsis for depth perception; (viii) evaluation ofcentral vision field (e.g., using the Amsler grid); (ix) cover test forstrabismus; (x) an optical coherency tomography (OCT) scan and/or slitlamp examination using biomicroscopy; (xi) examination of eyelids,conjunctiva, cornea, anterior chamber, iris and lens; (xii) measure eyepressure and/or intraocular pressure; (xiii) imaging of fundus using aretinal camera and examination of macula, vessels, optic nerve,peripheral retina, and vitreous humour. In certain cases, it may also beuseful to administer particular types of screenings to individuals forcertain diseases or disorders (e.g., glaucoma, macular degeneration orhypertensive retina), such as where there is individual and/or familyhistory of diseases or disorders.

Despite the known importance of regular eye health checkups and visionexaminations, many individuals only visit eye care professionals andreceive eye examinations on a highly sporadic basis. Other individualsfail to visit an eye care professional at all, or only do so in responseto suffering from a medical condition or recognizing a potential problemwith their vision. In fact, it is estimated that the average Americanadult receives an eye examination once every five years or more.Likewise, it is estimated that a large percentage of the individuals inAmerica who require some form of vision correction have the wrongcorrection or no correction. Moreover, even among the individuals thatundergo eye exams on a more frequent basis, the examinations received bythese individuals often fail to rise to the level of a comprehensive eyeexamination. For example, when visiting an eye care professional manyindividuals may simply receive a vision screening and/or a minimal setof visual acuity tests.

While there are various contributing factors, primary reasons why manyindividuals fail to regularly undergo eye examinations are based ontime, cost, and convenience. Typically, in order to obtain an eyeexamination, an individual required to expend time and effort to seekout, select and make an appointment with an appropriate eye careprofessional. In turn, time is spent traveling to and from thepractitioner's office, waiting for the practitioner, partaking indiscussions with the practitioner and/or nurse or assistant andundergoing the examination. Similarly, from the practitioner'sperspective, the number of patients that can be seen and examined arelimited by a number of factors, such as the time required to examineeach patient, update the patient's records, and prepare equipment. As aresult, individuals are frequently forced to visit eye careprofessionals at inconvenient times and/or travel to other, lessconveniently located professionals. Also, in order to maximize thenumber of patients that can be seen, practitioners may limit the numberof tests and procedures and/or the time spent on such tests, therebyreducing the time needed for each patient.

Additionally, the costs associated with visiting a practitioner candissuade, and even prohibit, many individuals from receiving eyeexaminations on a regular basis. This can be further compounded by thefact that many individuals lack insurance coverage for such examinationsand are required to pay some or all of the costs out of pocket. Thus,making regular visits to an eye care professional can often be atime-consuming, inconvenient and expensive commitment. Accordingly,there is a need for novel approaches to providing eye healthexaminations and vision examinations that minimize the time and costrequired by individuals, and thereby encourage individuals to obtainregular examinations.

There have been some attempts in the past to provide systems thatsimplify and automate the vision testing and examination process. Theseprior art systems, however, have exhibited a number of drawbacks andlimitations, which have resulted in their failure to be adopted byconsumers in any meaningful way. One such drawback is that many of thesesystems only provide vision screening or visual acuity testing.Similarly, many of these systems are limited to a restricted orincomplete set of procedures and tests and do not allow individuals toobtain a comprehensive eye examination. Another drawback is that many ofthese systems require an on-site eye care practitioner and/or operatorto provide some or all of the examination. Other such systems do notallow for any input or feedback from an eye care practitioner. Yetanother drawback is that none of these systems provide a real-timeinterface between the examinee and a remote practitioner. Still yetanother drawback is that many of these systems do not include anyfunctionality for automatically detecting or diagnosing potentialdisorders, defects or risk factors based on an individual's examinationdata and/or for automatically generating recommendations and/orreferrals.

There is, therefore, a need for an eye testing and evaluation system forproviding eye health examinations and vision examinations toindividuals. There is also a need for a system that allows individualsto obtain eye health examinations and vision examinations through auser-friendly customer diagnostic center that includes a wide range ofophthalmologic and vision testing equipment. There is further a need fora system which enables individuals to receive a comprehensive eyeexamination. There is further a need for a system having an automated orsemi-automated customer diagnostic center that allows individuals toobtain eye health examinations and vision examinations with little or noon-site assistance.

There is also a need for a system that provides an interface between thecustomer diagnostic center and a remote eye care practitioner over anetwork. to enable the practitioner to evaluate an individuals eyehealth and vision. There is further a need for a system that enables theremote practitioner to evaluate an individuals eye health and vision andprovides the individual with eye health reports, prescriptions,diagnoses, and/or recommendations from the remote practitioner. There isstill further a need for a system that allows a remote practitioner oroffsite technician to control or monitor the ophthalmologic and visiontesting equipment and/or the administration of various eye health andvision tests to individuals. There is still further a need for a systemthat can be accessed by individuals at a wide range of convenientlocations. There is still further a need for a system that encouragesindividuals to obtain eye health examinations and vision examinations ona regular basis by reducing the time and cost required.

SUMMARY OF THE INVENTION

In accordance with the certain embodiments, a system is provided thatincludes a customer diagnostic center that is configured to generatecustomer examination data pertaining to an examination of a customer'seye and vision. The customer diagnostic center provides a user interfacefor receiving input and providing information to a customer. Thecustomer diagnostic center also includes ophthalmic equipment foradministering tests to the customer and an equipment controllerconfigured to control the operation of the ophthalmic equipment. Adiagnostic center server is configured to receive the customerexamination data from the customer diagnostic center over a network andallow the customer examination data to be accessed by an eye-carepractitioner. A practitioner device associated with the eye-carepractitioner is configured to receive at least a portion of the customerexamination data from the diagnostic center server and display thereceived customer examination data to the eye-care practitioner.Customer evaluation data is generated pertaining to the eye-carepractitioner's review and evaluation of the customer examination data.An eye health report is provided to the customer via the network.

In accordance with certain embodiments, a method is provided for eyehealth and vision examinations. The method includes generating customerexamination data pertaining to an examination of a customer's eye at acustomer diagnostic center. The customer diagnostic center includes auser interface for receiving input from, and providing information to,the customer. The customer diagnostic center also includes ophthalmicequipment for administering tests to the customer and an equipmentcontroller configured to control the operation of the ophthalmicequipment. Customer examination data is received from the customerdiagnostic center over a computer network at a diagnostic center server.The diagnostic center server permits the customer examination data to beaccessed by an eye-care practitioner. The customer examination data isreceived at a practitioner device associated with the eye-carepractitioner from the diagnostic center server. At least a portion ofthe customer examination data is displayed to the eye-care practitioner.Customer evaluation data pertaining to the eye-care practitioner'sreview and evaluation of the customer examination data is generated. Aneye health report based, at least in part, on the customer evaluationdata is provided to the customer via the network.

In accordance with certain embodiments, a server is configured toprovide services associated with eye health and vision examinations. Theserver is configured to receive customer examination data over acomputer network pertaining to an examination of a customer's eyeadministered at a customer diagnostic center. The customer diagnosticcenter includes a user interface for receiving input from, and providinginformation to, the customer. The customer diagnostic center alsoincludes ophthalmic equipment for administering tests to the customerand an equipment controller configured to control the operation of theophthalmic equipment. The server is configured to provide access to thecustomer examination data by an eye-care practitioner and to transmitthe customer examination data from the diagnostic center server to apractitioner device associated with the eye-care practitioner. Theserver is further configured to receive customer evaluation datapertaining to the eye-care practitioner's review and evaluation of thecustomer examination data. An eye health report based, at least in part,on the customer evaluation data is provided to the customer via thenetwork.

In accordance with certain embodiments, a system is configured toprovide eye health and vision examinations. The system includes aplurality of diagnostic centers which are configured to transmitrequests over a network for selecting eye-care practitioners toadminister eye examinations for customers and to receive instructionsover the network to remotely control operation of ophthalmic equipmentin order to administer one or more tests pertaining to the eyeexaminations. The diagnostic centers are also configured to generatecustomer examination data pertaining to the one or more testsadministered using the ophthalmic equipment. The system also includes aplurality of practitioner devices associated with eye-care practitionerswhich are configured to receive and display at least a portion of thecustomer examination data in response to accepting one or more of therequests and to generate customer evaluation data associated with theone or more accepted requests. The system further includes at least oneserver. In response to receiving the requests from the diagnosticcenters, the server analyzes practitioner data to select eye-carepractitioners for handling the requests. The practitioner data maycomprise availability data indicating whether the eye-care practitionersare currently connected to the system and available to administer eyeexaminations, scheduling data indicating days and hours that theeye-care practitioners are available to handle the requests and priorcustomer data that identifies customers who utilized the eye-carepractitioners for prior eye examinations. The server is configured toreceive the customer examination data from the diagnostic centers and totransmit the customer examination data to the practitioner devicesassociated with the selected eye-care practitioners. The server isfurther configured to receive customer evaluation data from thepractitioner devices associated with the selected eye-carepractitioners. Eye health reports based, at least in part, on theselected eye-care practitioners' review and evaluation of the customerexamination data are provided to the customers.

In accordance with certain embodiments, a server is configured toprovide services related to eye health and vision examinations. Arequest is received by the server over a network from a diagnosticcenter for selecting an eye-care practitioner to administer an eyeexamination to a customer. In response to receiving the request, theserver analyzes practitioner data to select the eye-care practitionerfor handling the request. The practitioner data includes availabilitydata indicating which eye-care practitioners are currently available toadminister the eye examination, scheduling data indicating days andhours that eye-care practitioners are available to handle requests andprior customer data that identifies one or more eye-care practitionerswho previously administered eye examinations to the customer. The serveris further configured to receive customer examination data generated byophthalmic equipment at the diagnostic center while administering one ormore tests pertaining to the eye examination and to transmit customerexamination data pertaining to the one or more tests to the practitionerdevice associated with the selected eye-care practitioner. Customerevaluation data is received from the practitioner device associated withthe selected eye-care practitioner. An eye health report based, at leastin part, on the selected eye-care practitioner's review and evaluationof the customer examination data is provided to the customer.

These and other features and advantages will become apparent from thefollowing detailed description of illustrative embodiments thereof,which is to be read in connection with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The inventive principles are illustrated in the figures of theaccompanying drawings which are meant to be exemplary and not limiting,in which like references are intended to refer to like or correspondingparts, and in which:

FIG. 1 is a pictorial diagram of an eye testing and evaluation system inaccordance with certain embodiments of the present invention.

FIG. 2 is a pictorial diagram of an eye testing and evaluation system inaccordance with certain embodiments of the present invention.

FIG. 3 is a block diagram illustrating a portion of the components of acustomer diagnostic center that may be used with the eye testing andevaluation system in accordance with certain embodiments.

FIG. 4 is a block diagram illustrating a portion of a customerdiagnostic center having a vision examination system in accordance withcertain embodiments of the present invention.

FIG. 5 is a block diagram illustrating a portion of a customerdiagnostic center having an eye health examination system in accordancewith certain embodiments of the present invention.

FIG. 6 is a flow chart illustrating an exemplary method foradministering an eye testing and evaluation service in accordance withcertain embodiments of the present invention.

FIG. 7 is a flow chart illustrating an exemplary method foradministering a synchronous vision examination in accordance withcertain embodiments of the present invention.

FIG. 8 is a flow chart illustrating an exemplary method foradministering an asynchronous vision examination in accordance withcertain embodiments of the present invention.

FIG. 9 is a flow chart illustrating an exemplary method foradministering a synchronous eye health examination in accordance withcertain embodiments of the present invention.

FIG. 10 is a flow chart illustrating an exemplary method foradministering an asynchronous eye health examination in accordance withcertain embodiments of the present invention.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION

In the following description, reference is made to the accompanyingdrawings that form a part hereof, and in which is shown by way ofillustration specific embodiments in which the invention may bepracticed. It is to be understood that other embodiments may be utilizedand structural changes may be made without departing from the scope ofthe present invention.

It is well-known that eye health examinations and vision examinationsprovide many important benefits and, accordingly, virtually allhighly-regarded associations and professionals throughout the field ofeye and vision care strongly recommend that individuals receive suchexaminations and screenings on a regular and consistent basis.Nevertheless, many individuals fail to undergo eye health examinationsand vision examinations at all, or only do sporadically or in responseto an immediate medical issue or condition. In part, many individualsfind it challenging to obtain regular examinations because of thesignificant time, cost and inconvenience that can be required inconnection with finding an eye care professional, making an appointmentand visiting the professional's office to receive the examination. Toencourage regular eye health examinations and vision examinations bysuch individuals and others, systems and methods are provided hereinthat allow individuals to obtain eye health examinations and visionexaminations through customer diagnostic centers at a wide range ofconvenient locations, thereby reducing the time and expense incurred bysuch individuals.

Certain embodiments of the present invention pertain to an eye testingand evaluation system, including devices, general hardware componentsand computer hardware and software for providing eye health examinationsand/or vision examinations to customers (i.e., any individual desiringeye health examinations and/or vision examinations). According tocertain of these embodiments, the customers may receive the eye healthexaminations and/or vision examinations at a customer diagnostic centerthat includes various ophthalmologic and/or vision testing equipment andinstruments for administering a range of tests and procedures andcollecting various data pertaining to the customers' eyes and vision. Incertain embodiments, the customer diagnostic center interfaces with aremote practitioner (e.g., ophthalmologist, optometrist, or othersuitable eye doctor or eye care professional) through a network.According to certain of these embodiments, various data, including datapertaining to a customer and data associated with the eye health andvision tests and procedures administered to the customer is provided tothe remote practitioner for analysis, diagnosis and/or confirmation. Incertain embodiments, an eye health report, optical prescription,recommendations and/or referrals based on the customer and testing dataare received from the remote practitioner and provided to the customer.Certain embodiments enable the ophthalmologic and/or vision testingequipment in the customer diagnostic center and/or the administration ofvarious tests and procedures to be controlled or monitored by the remotepractitioner or an off-site technician via a remote equipment interface.

The eye testing and evaluation system, corresponding arrangements andsystems, apparatuses, and methods described below address many of thehurdles and restrictions that currently exist with respect toadministering eye health examinations and vision examinations toindividuals and encourages individuals to undergo such examinations andexaminations on a regular and consistent basis by providing customerdiagnostic centers at various convenient locations that allowindividuals to obtain eye health examinations and vision examinationswith little or no assistance, thereby minimizing the time, effort, andcost involved.

Eye Testing and Evaluation System Architecture

In certain embodiments, the eye testing and evaluation system may beprovided through any suitable form of general hardware components anddevices, computer hardware and software, or a combination of any of theforegoing, that allows customers to obtain eye health examinationsand/or vision examinations. The eye health examinations and/or visionexaminations may include comprehensive examinations and/or screenings.Exemplary illustrations of the architecture of the eye testing andevaluation system and accompanying apparatuses, systems and components,in accordance with certain embodiments, are shown in FIGS. 1-2 anddescribed below. As shown in FIGS. 1-2, the system may include variouscomponents and subcomponents, such as apparatuses, equipment, servers,processors, networks, and personal devices which are part of the eyetesting and evaluation system.

It is to be understood that the components depicted may be logicalcomponents and that the terminology used herein to describe eachcomponent is for illustrative purposes and is not to be construed aslimiting. Each component and subcomponent may include the necessaryapparatuses, devices and computer hardware, software and firmware toenable the collecting, measuring, processing, storing, communicating,presenting and/or receiving of data. A component or subcomponent mayinclude one or more electronic components, mechanical components,instruments, computer processors, computer servers, data stores, storagemediums, memory, etc. The functionality of a component may be directedby one or more executable computer-readable instructions received via acomputer-readable storage medium. A processor may be included to executeone or more functions per instructions, programs, or processes stored inthe processor itself and/or stored in another memory source. Memory maybe any mechanism that is capable of storing data, such as computerprograms, instructions, and other necessary data. One or more interfacesmay be included to enable the presentation, manipulation, transmission,and receipt of data. Communication of data may be enabled by one or morenetworks or physical connections. Any data transmitted by or betweencomponents may be encrypted for security purposes (e.g., with a 256-bitadvanced encryption algorithm). A network may include one or morewide-area networks (WAN) (such as the Internet), local area networks(LAN), wireless local area networks (WLAN), a mobile wireless network, acombination of any of the foregoing, and/or any other suitable networksand may include any component (physical or logical) necessary forutilizing a particular network's functionality, such as routers,adapters, subnets, etc.

FIG. 1 is a pictorial diagram of an eye testing and evaluation system100 in accordance with certain embodiments. As shown in FIG. 1, thesystem includes customer diagnostic center 10 having various components,such as general hardware components, mechanical devices, electronicequipment, computer hardware and software and other suitable componentsfor allowing customers to receive eye health examinations and/or visionexaminations. In certain embodiments, customer diagnostic center 10includes various ophthalmic equipment and instruments, such asrefractors, lensometers, tonometers, biomicroscopes, etc., foradministering a range of tests and procedures to customers. In certainembodiments, customer diagnostic center 10 includes one or moreinterfaces, such as a customer interface for receiving inputs,selections, responses and other data from customers and outputtingvarious information to the customers. Customer diagnostic center 10 mayalso include a network interface for communicating with various othersystems and devices over one or more networks, such as network 50 shownin FIG. 1. In certain embodiments, customer diagnostic center 10 mayinclude an operator interface for allowing an onsite technician oroperator to monitor or control the ophthalmic equipment and instruments(or a portion thereof) and/or the administration of tests and proceduresto customers.

According to certain embodiments, customer diagnostic center 10 mayinclude computer hardware, software, or a combination thereof, such asprocessors, memory, controllers, applications, and other suitablecomputing devices and components that control the overall operation ofcustomer diagnostic center 10. For example, these components mayfacilitate the administration of eye health examinations and visionexaminations, process data received from customers and operators anddata generated by the ophthalmic equipment and instruments, and/ormanage the communication of data to and from other systems and devicesover a network. The devices, equipment, computer hardware and softwareand other components that may be included within and/or utilized bycustomer diagnostic center 10 are further illustrated and describedbelow in connection with FIGS. 3-5.

In certain embodiments, customer diagnostic center 10 may be provided inthe form of a self-contained structure, such as a booth or othersuitable enclosure. In certain of these embodiments a number ofstructures may be provided, each of which may include certain componentsof customer diagnostic center 10. In certain of these embodiments,customer diagnostic center 10 may be of sufficient size to allowcustomers to enter and/or sit down therein. According to certain otherembodiments, customer diagnostic center 10 (or a portion thereof) may beprovided in a free-standing form, such as a kiosk, terminal, or thelike, or may be incorporated within one or more existing structures,such as eyeglass or contact lens dispensing machines or other types ofdevices associated with viewing, trying-on (e.g., physically orvirtually), customizing, ordering and/or purchasing eyeglasses andcontact lenses. According to yet other embodiments customer diagnosticcenter 10 may be provided in any structure or form that is suitable forhousing the various components described herein and allowing customersto receive eye-health examinations and vision examinations.

Customer diagnostic center 10 may be provided in a wide range oflocations and environments. For example, in certain embodiments,customer diagnostic center 10 may be provided at various shoppinglocations, such a retail store, malls, event centers, office buildings,or other indoor spaces. In certain of these embodiments, customerdiagnostic center 10 may be located within a retail store, office or thelike that is associated with providing one or more eye care and/orvision products or services, such as an eye clinic, prescription lenslab or store, or optician's, optometrist's or ophthalmologist's office.As another example, customer diagnostic center 10 may be provided atvarious outdoor locations and environments, such as strip malls, outletmalls, or town centers. In certain embodiments, customer diagnosticcenter 10 may be provided at the home or residence of a customer orindividual seeking an examination. In certain other embodiments,customer diagnostic center 10 may be provided at virtually any locationor environment that is suitable for allowing customers to accesscustomer diagnostic center 10 and receive eye-health examinations andvision examinations. In certain embodiments, customer diagnostic center10 may be provided as a fixed structure or device or may be designed tobe portable or mobile.

As illustrated in FIG. 1, the eye testing and evaluation system mayinclude customer diagnostic center server (CDC server) 20, which may bein the form of computer hardware, software, or a combination thereof,including any number of physical or virtual computer servers, or anyother suitable computing device or devices. In certain embodiments, CDCserver 20 and/or database server 10 may be hosted and operated by theowner or operator of customer diagnostic center 10. In certain otherembodiments, CDC server 20 and/or database server 10 may be hosted andoperated by one or more third-party service providers. According tocertain of these embodiments, customer diagnostic center 10 and CDCserver 20 may communicate with each other through network 50, which maybe any suitable type of wired and/or wireless network. such as anInternet network.

In certain embodiments, CDC server 20 may provide various services andfunctionality required by, and/or manage or control certainfunctionality associated with, customer diagnostic center 10. Forexample, in certain embodiments, CDC server 20 may be responsible forstoring, maintaining, updating, processing and/or providing access to,various data received from or used by customer diagnostic center 10,such as data pertaining to customers, examination results dataassociated with tests and procedures administered through the customerdiagnostic center 10, and/or practitioner evaluation data pertaining toa remote practitioners review, diagnoses, and evaluation of theexamination results data. In certain embodiments, CDC server 20 maystore video recordings of examinations and tests performed at customerdiagnostic center 10 and permit practitioners to access the recordingsremotely. In certain embodiments, CDC server 20 may store introductoryvideos and/or advertisements that are transmitted to customer diagnosticcenter 10 and displayed to customers at customer diagnostic center 10prior to administering tests and/or procedures to the customer. CDCserver 20 may also store, maintain and/or provide access to datareceived from or associated with other sources, such as medical historydata and prior examination data for customers, testing data pertainingto the tests and procedures available through customer diagnostic center10 and/or product data, promotional data and advertising data associatedwith eye care and vision related products and services provided byvarious third parties. In certain of these embodiments, CDC server 20may also utilize one or more database servers, such as database server22 shown in FIG. 1, to facilitate the storage, organization, andretrieval of some or all of the data maintained by CDC server 20 in oneor more databases maintained by database server 22. CDC server 20 mayaccess database server 22 through any suitable connection, such as aphysical connection, local network, and/or network 50.

As another example, CDC server 20 may be responsible for managing,controlling, and/or updating certain functionality associated withcustomer diagnostic center 10. In certain embodiments, CDC server 20 maystore various software, programs, instructions, testing data and otherinformation that is used by customer diagnostic center 10 in connectionwith enabling customers to access and obtain eye health examinations andvision examinations, controlling the ophthalmic equipment andinstruments, and/or providing and administering tests and procedures tocustomers. As yet another example, CDC server 20 may be responsible formanaging and facilitating the establishment of connections and/orcommunication of data between customer diagnostic center 10 and variousother systems and devices over one or more networks, such as devicesassociated with a remote eye care practitioner or offsite technician,devices associated with customers, and/or systems associated with thirdparty providers of eye care and vision products and services.

Although CDC server 20 and database server 22 are shown in FIG. 1 forillustrative purposes, it should be understood that in certainembodiments the functionality provided by CDC server 20 and/or databaseserver 22, may be provided by any number of servers, or other suitablecomputing hardware, software and/or devices. Alternatively, oradditionally, some or all of the functionality provided by CDC server 20and/or database server 22 may be integrated with customer diagnosticcenter 10. In certain other embodiments, CDC server 20 and/or databaseserver 22 may be directly connected to customer diagnostic center 10.

In certain embodiments, customer diagnostic center 10 and/or CDC server20 may interface with a remote eye care practitioner through one or moredevices associated with the practitioner, such as remote practitionerdevice 30 shown in FIG. 1. Remote practitioner device 30 may be acomputing device, such as a personal computer, workstation, laptop,tablet, smartphone, or PDA, or any other suitable device of that enablesa remote practitioner to receive, access, view, and/or send data overone or more networks (e.g., network 50). In certain embodiments, theremote eye care practitioner may be a licensed optometrist orophthalmologist. In certain other embodiments, the remote eye carepractitioner may be any eye care professional or other individual who isqualified, licensed, or otherwise capable of administering or monitoringone or more eye health and visual acuity tests and procedures and/orreviewing, analyzing and providing diagnoses, reports, prescriptions orrecommendations based upon the data and results associated withadministering such tests and procedures.

According to certain embodiments, various data associated with the eyehealth examinations and vision examinations administered to thecustomers through customer diagnostic center 10 may be sent to (or madeaccessible to) the remote practitioner at remote practitioner device 30.For example, in response to a customer accessing customer diagnosticcenter 10 and receiving certain eye health and vision tests, customerexamination data may be sent to remote practitioner device 30 for reviewby the remote practitioner. In certain embodiments, the customerexamination data may include data pertaining to the customer (e.g., thecustomer's name, age, gender, race, medical history, prior test results,etc.) and data associated with one or more of the tests administered tothe customer (e.g., responses, inputs and selections from the customer,instrument measurements and readings, test results, etc.). In certainembodiments, the customer examination data may include a real-time videostream that permits the remote eye care practitioner to view the patientas tests, procedures and examinations are provided to the customer, ormay include a video recording that permits the remote eye carepractitioner to view tests, procedures and examinations that werepreviously administered to the customer. In certain of these embodimentsthe customer examination data may also include various other data thatenables the remote practitioner to (or assists the remote practitionerwith) evaluate the customer's eye health and visual ability, detect anddiagnose certain disorders, defects and conditions and/or confirm thatone or more of the tests and procedures were administered correctly.

In certain embodiments, customer evaluation data may be received fromthe remote practitioner via remote practitioner device 30 that is basedon the remote practitioner's review and evaluation of the customerexamination data. The customer evaluation data received from the remotepractitioner may include various reports, diagnoses, recommendations andother information indicating the results of the eye health and visiontests and procedures administered to the customer. For example, incertain of these embodiments the customer evaluation data may include aneye health report (or may be used to generate an eye health report) thatmay include an overview of the customer's eye health, visual acuity, theresults of one or more tests and procedures, diagnoses of one or moreeye or vision disorders or conditions, optical prescriptions,pharmaceutical prescriptions, recommendations, treatment instructions,and/or referrals to see other eye care professionals. In certainembodiments, the eye health report and/or customer evaluation data (or aportion thereof) may be provided to the customer, such as by presentingthe eye health report to the customer through diagnostic center 10and/or allowing the customer to access the eye health report from one ormore computing devices associated with the customer.

According to certain embodiments, the communication of some or all ofthe data sent to and received from the remote practitioner (e.g.,customer examination data and customer evaluation data) may be managedand facilitated by CDC server 20. For example, in response to a customerreceiving an eye health examination and/or vision examination atcustomer diagnostic center 10, CDC server 20 may store various data(e.g., customer data, testing data, etc.) received from customerdiagnostic center 10 and manage the delivery of the correspondingcustomer examination data to the remote practitioner. In certain ofthese embodiments, CDC server 20 may send the customer examination datato remote practitioner device 30 through any suitable deliverymechanism, such as e-mail, text message, file transfer, etc.Alternatively, or additionally, the remote practitioner may be able toaccess, view and/or download the customer examination data from CDCserver 20, such as by using remote practitioner device 30 to access thecustomer examination data through a web-based service or similarnetwork-based application hosted by CDC server 20 and/or a clientapplication installed on remote practitioner device 30 that is adaptedto connect to CDC server 20.

In turn, the receipt of various data from the remote practitioner may bemanaged by CDC server 20 in a similar manner. For example, afterreceiving and reviewing the customer examination data, the remotepractitioner may send the customer evaluation data to CDC server 20. Incertain embodiments, such as where the customer examination data may beaccessed and viewed through a web-based service or client application,the remote practitioner may also be able to generate and/or provide thecustomer evaluation data through the web-based service or clientapplication. In certain of these embodiments, the web-based service orclient application may assist the remote practitioner with the processof creating the customer evaluation data, such as by providing agraphical user interface or the like that allows the remote practitionerto make selections, input, upload and edit various data, and generatevarious reports. In certain other embodiments, CDC server 20 may receivethe customer evaluation data from the remote practitioner through anysuitable delivery mechanism, such as email.

According to certain other embodiments, CDC server 20 may facilitateand/or establish a connection between customer diagnostic center 10 andremote practitioner device 30 in order to allow the direct communicationof certain data between customer diagnostic center 10 and remotepractitioner device 30. In certain of these embodiments, a real-timeconnection may be established between customer diagnostic center 10 andremote practitioner device 30, which allows the remote practitioner toview and interact with a customer, access and view customer examinationdata, and/or provide customer evaluation data to the customer inreal-time, such as during (or shortly after) the administration of oneor more eye health and vision tests. The remote practitioner may also beable to monitor and control certain ophthalmic equipment and instrumentsand/or the administration of one or more eye health and vision tests inreal-time. As an alternative (or in addition), CDC server 20 mayestablish a real-time connection between customer diagnostic center 10and a device associated with an offsite technician (e.g., an equipmentoperator or the remote practitioner's assistant, etc.) for monitoringand/or controlling the equipment and the administration of the tests.The process of establishing connections with and communicating variousdata to and from various devices associated with remote practitionersand off-site technicians is described in further detail below.

In certain embodiments, CDC server 20 may also manage the communicationof certain data to various other systems and devices. For example, asshown in FIG. 1, in certain embodiments, after receiving an eye healthexamination and/or vision examination through customer diagnostic center10, customers may be able to access some or all of the data associatedwith their examination or examination (e.g., an eye health report) fromvarious devices, such as customer device 40 via network 50. Customerdevice 40 may be any suitable type of computing device that isassociated with the customer, such as a personal computer, laptop,tablet, PDA, smartphone, etc. In certain of these embodiments, the datamay be delivered and/or made accessible to customers through a web ornetwork based service provided by CDC server 20 or a client applicationinstalled on customer device 40 in a similar manner to that describedabove in connection with communicating with the remote practitioner. Incertain embodiments, customers may also be able to view, input and/orupdate other information, such as their customer data. Additionally,customers who have not yet received an eye health examination or visionexamination through customer diagnostic center 10 may be able to entercertain background information and/or create an account in advance, suchas to avoid having to provide this information when visiting customerdiagnostic center 10.

As another example, CDC server 20 may forward certain data associatedwith customers and their eye health examinations and/or visionexaminations to a third party provider of eye-care and vision relatedproducts and services, such as to an optical lab through optical labserver 90 (as shown in FIG. 1) or to an eye care professional (notshown) through network 50. In certain of these embodiments the data mayonly be sent to a third party provider in response to receiving arequest from the customer. In certain other embodiments, CDC server 20may be configured to automatically deliver certain data to one or morethird party providers, such as in response to receiving customerevaluation data from a remote practitioner that includes arecommendation and/or referral for the customer to visit an eye careprofessional in-person.

Although the foregoing describes various examples in which CDC server 20manages, facilitates, and/or controls the communication of certain datato one or more devices and systems (e.g., remote practitioner device 30and customer device 40), these examples are intended to be illustrative,not limiting. It should be understood that these (and various other)communications could be managed, facilitated, and/or controlled by oneor more other devices or components included with the eye testing andexamination system, and/or various third-party or external systems,devices and components. For example, in certain embodiments, such aswhere customer diagnostic center 10 incorporates some or all of thefunctionality associated with CDC server 20 and/or database server 22,customer diagnostic center 10 may send customer examination datadirectly to remote practitioner device 30 and/or make the dataaccessible to remote practitioner device 30 via a web or network basedservice or through a client software application. Likewise, in certainembodiments, customer diagnostic center 10 may establish a real-timeconnection with remote practitioner device 30 and/or a device associatedwith an off-site technician, and may manage the communication of data toand from various other systems and devices, such as customer device 40and/or optical lab server 90.

FIG. 2 is a pictorial diagram of an eye testing and evaluation system inaccordance with certain other embodiments. In certain embodiments, theeye testing and evaluation system may include a number of customerdiagnostic centers. For example, as shown in FIG. 2, the eye testing andevaluation system may include customer diagnostic centers 10A-10E. Incertain embodiments, customer diagnostic centers 10A-10E may be in aform similar to the customer diagnostic centers illustrated anddescribed in connection with FIGS. 1 and 3-5 (e.g., customer diagnosticcenter 10). In certain other embodiments, some or all of customerdiagnostic centers 10A-10E may include a limited set of componentsand/or provide a limited set of features and functionality. For example,customer diagnostic centers 10A and 10C may be configured to providecustomers with vision examinations, customer diagnostic centers 10B and10D may be configured to provide customers with eye health examinationsand customer diagnostic center 10E may be configured to providecustomers with vision examinations and eye health examinations. Thevision examinations and eye health examinations may include bothcomprehensive examinations and screenings (e.g., screenings that maynecessitate a referral to a specialist for further evaluation). In yetother embodiments, one or more of the customer diagnostic centers mayinclude additional components and/or provide additional features andfunctionality, such as functionality related to ordering and purchasingeye care and vision products and services.

In certain embodiments, customer diagnostic centers 10A-10E may all beowned, operated and/or maintained by the same party, such as a thirdparty associated with the manufacture and/or servicing of the customerdiagnostic centers or a company associated with the sale of various eyecare and vision products and services. For example, customer diagnosticcenters 10A-10E may each be provided at a retail store or other physicallocation that is associated with an optician or prescription lenscompany. In certain other embodiments, customer diagnostic centers10A-10E may be owned, operated and/or maintained by a number ofdifferent third parties. According to certain preferred embodiments, thecustomer diagnostic centers may be provided at a wide range of locationsand environments (e.g., retail stores, department stores, malls,doctor's offices, etc.), thereby making it as convenient as possible forcustomers to locate and visit a customer diagnostic center and obtaineye health examinations and vision examinations.

In certain embodiments, customer diagnostic centers 10A-10E mayinterface with a number of CDC servers over one or more networks (suchas network 50 shown in FIG. 1). For example, as shown in FIG. 2,customer diagnostic centers 10A and 10B may interface with CDC server20A, customer diagnostic centers 10C and 10D may interface with CDCserver 20B, and customer diagnostic center 10E may interface with CDCserver 20C. In certain of these embodiments, CDC servers 20A-20C maymanage or control certain operations of customer diagnostic centers10A-10E, provide various functionality and resources used by customerdiagnostic centers 10A-10E, and/or enable or facilitate certaincommunications between customer diagnostic centers 10A-10E and variousother systems and devices, in a similar manner to that of CDC server 20described above in connection with FIG. 1. In certain embodiments, CDCservers 20A-20C may be provided in the form of separate physicalcomputer servers, or may be provided in the form of virtual serversrunning on a one or more physical computer servers. In certain otherembodiments, the functionality associated with CDC servers 20A-20C maybe incorporated with a single CDC server (e.g., CDC server 20 shown inFIG. 1), which interfaces with customer diagnostic centers 10A-10E.

In certain embodiments, such as illustrated in FIG. 2, each CDC servermay interface with a subset of the customer diagnostic centers that areprovided through the eye testing and evaluation system. For example,each CDC server may be associated with a particular predefined subset ofcustomer diagnostic centers. As another example, a CDC server may beassociated with customer diagnostic centers that are located within aspecified geographic region (e.g., a city, state, etc.) and/or customerdiagnostic centers that are owned or operated by a particular thirdparty (e.g., a prescription lens retailer). In certain otherembodiments, a separate CDC server may be included for each customerdiagnostic center that is provided through the eye testing andevaluation system (i.e., a one-to-one relationship). Additionally, whileFIG. 2 shows each customer diagnostic center interfacing with a singleCDC server, in certain embodiments, customer diagnostic centers 10A-10Emay be able to interface with multiple CDC servers.

According to certain embodiments, CDC servers 20A-20C may interface withone or more database servers, such as database servers 22A-22C shown inFIG. 2. For example, CDC servers 20A-20C may utilize database servers22A-22C, respectively, to store, retrieve, and access various data thatis generated by, related to, and/or used by the customer diagnosticcenters, such as customer data, testing administration data, customerexamination data, and customer evaluation data, in a similar manner tothat described in connection with FIG. 1. In certain of theseembodiments, each CDC server may utilize a separate database server (orservers) to store the data that is associated with the particularcustomer diagnostic centers that are managed or controlled by the CDCserver. In certain other embodiments, a central database server (orgroup of database servers) may be provided that is accessed and utilizedby some or all of the CDC servers. One benefit to the use of a centraldatabase is that it enables data associated with a particular customerdiagnostic center to be accessed quickly and efficiently at variousother customer diagnostic centers, such as where a customer visits anumber of customer diagnostic centers at different times.

In certain embodiments, such as where customer examination data and/orother information is provided to a remote practitioner for review andanalysis of a customer's eye health or visual ability, customerdiagnostic centers 10A-10E and/or CDC servers 20A-20C may communicatewith a number of remote practitioners. For example, customer diagnosticcenters 10A-10E and/or CDC servers 20A-20C may communicate with remotepractitioners through remote practitioner devices 30A-30D, as shown inFIG. 2. In certain of these embodiments, the remote practitioner devicesmay include a wide range of computing devices, such as remotepractitioner workstation 30A, remote practitioner smartphone 30B, remotepractitioner laptop 30C and remote practitioner tablet 30D. Remotepractitioner devices 30A-30D may include devices that are associatedwith a particular remote practitioner (e.g., a personal smartphone, PC,or tablet), devices that are associated with a number of remotepractitioners (e.g., a workstation or company laptop) and/or acombination of the foregoing.

In certain of embodiments, customer diagnostic centers 10A-10E and/orCDC servers 20A-20C may communicate with remote practitioner devices30A-30D over one or more networks using any suitable communicationsmechanisms and/or protocols, such as those described above in connectionwith FIG. 1. For example, customer diagnostic centers 10A-10E and/or CDCservers 20A-20C may send data to and/or receive data from remotepractitioner devices 30A-30D through one or more standard transfermechanisms (e.g., e-mail). Alternatively, or in addition, customerdiagnostic centers 10A-10E and/or CDC servers 20A-20C may provide datato and receive data from the remote practitioners through aclient-server framework, such as a web based service hosted by CDCservers 20A-20C and accessed by remote practitioner devices 30A-30D(e.g., via a web browser) or a client application installed on remotepractitioner devices 30A-30D that connects to a server applicationrunning on CDC servers 20A-20C.

As illustrated in FIG. 2, some or all of the communications andconnections between remote practitioner devices 30A-30D and customerdiagnostic centers 10A-10E and/or CDC servers 20A-20C may be facilitatedby one or more intermediary servers, such as remote practitionermanagement (RPM) server 24. In certain embodiments, RPM server 24 maysimply act as a central gateway or proxy server that provides variousinterfaces through which data can be communicated to and received fromthe remote practitioner devices. In certain other embodiments, RPMserver 24 may play a more active role and provide various features andfunctionality associated with managing, controlling and/or tracking thecommunications and/or connections with the remote practitioner devices.For example, RPM server 24 may keep track of the remote practitionersand/or remote practitioner devices that are associated with the eyetesting and evaluation system and/or manage the distribution of data tothe remote practitioners. In certain embodiments, the RPM server 24 maymaintain a listing of remote practitioners, remote practitioner devices30, customer diagnostic centers 10 and any other component or individualthat is currently connected to the eye testing and evaluation system.The listing may be utilized to establish a connection between a remotepractitioner device 30 and a customer diagnostic center 10.

In certain embodiments, RPM server 24 may utilize one or more databaseservers, such as practitioner database server 26 shown in FIG. 2, tostore and access various data pertaining to the remote practitioners andthe remote practitioner devices. Among other things, the practitionerdata may include certain background information for each remotepractitioner (e.g., name, age, qualifications, location, etc.), dataindicating one or more remote practitioner devices associated with eachremote practitioner and/or data pertaining to one or more communicationmechanisms through which data may be delivered to and/or made accessibleto the remote practitioners. In turn, RPM server 24 may access and usethe practitioner data (or a portion thereof) in a number of manners.

For example, RPM server 24 may use the practitioner data in connectionwith forwarding data from the CDC servers and/or customer diagnosticcenters to remote practitioners, such as to determine how the datashould be delivered (e.g., e-mail, through a client application, etc.)and/or where the data should be delivered (e.g., determine one or moreremote practitioner devices). Similarly, the practitioner data may beused to confirm whether data should be delivered to a particular remotepractitioner (e.g., whether the remote practitioner is currentlyproviding services through the system, connected to the system orwhether the remote practitioner has certain required qualifications orexpertise). As another example, RPM server 24 may provide some or all ofthe practitioner data to the CDC servers and/or customer diagnosticcenters, such as to allow a customer to view and/or select from one ormore remote practitioners, and/or to enable the CDC servers or customerdiagnostic centers to determine remote practitioners to communicatewith. In certain of these embodiments, the practitioner data may keeptrack of the customers for which each remote practitioner has reviewedexamination data and/or provided eye health reports, opticalprescriptions, etc., thereby allowing RPM server 24 (or the CDC serversor customer diagnostic center) to determine whether the data for acurrent customer can be sent to a remote practitioner that may alreadybe familiar with the customer (e.g., in the case that the remotepractitioner previously examined or interacted with the customer).

In certain embodiments, the practitioner data may store data thatpertains to the availability and/or status of each remote practitioner.This data may include, for example, information related to a remotepractitioner's schedule, the days and/or hours that a remotepractitioner is available to review customer examination data throughthe system, whether the remote practitioner is on vacation, etc. Theavailability data may be used in various ways to manage thecommunication of data to the remote practitioners, such as determiningwhether a particular remote practitioner is able to review customerexamination data, and/or providing a list of the currently availableremote practitioners to the CDC servers and/or customer diagnosticcenters. In certain of these embodiments, such as where a real-timeconnection is established between customer diagnostic centers and remotepractitioners, the availability data may include an indication ofwhether each remote practitioner is online and/or available forconnecting to a customer diagnostic center (e.g., is not alreadyconnected to a customer diagnostic center, has a sufficient networkconnection, is using a supported remote practitioner device, etc.).

Likewise, the practitioner data may include data that is associated withmonitoring and tracking the current workload of the remote practitionersthrough the system (e.g., the number of customers for which each remotepractitioner is in the process of reviewing and analyzing examinationdata). In turn, this data can be used by RPM server 24 to determine andselect the remote practitioners who have availability to reviewexamination data associated with additional customers. Alternatively, oradditionally, this tracking data may be used to determine or prioritizethe remote practitioners that should be assigned customer examinationdata as it is received, such as by keeping a list of the remotepractitioners that is ordered based on how long it has been sincecustomer examination data was provided to each remote practitioner.Accordingly, by monitoring and tracking the workload of the remotepractitioners, RPM server 24 is able to distribute the customerexamination data to the pool of remote practitioners in a balancedmanner, thereby minimizing the amount of time each customer has to waitbefore receiving customer evaluation data (e.g., eye health report,diagnoses, optical prescriptions, etc.) from a remote practitioner.

According to certain embodiments, some or all of the practitioner datamay be obtained, tracked and/or updated on a regular, periodic orreal-time basis using various mechanisms. For example, in certainembodiments, RPM server 24 (and/or the CDC servers or customerdiagnostic centers) may regularly query the remote practitioners (e.g.,by sending an e-mail to the remote practitioners each week) in order torequest that the remote practitioners provide and/or update certaininformation, such as their upcoming schedules or periods ofunavailability. In certain other embodiments, such as where the remotepractitioners can review and/or respond to customer examination datathrough a web-based service or client application, the remotepractitioners may be prompted to provide and update this informationwhen they access the service or application (e.g., when they login to awebsite or launch an application on their device, etc.). Similarly, inthe case where real-time connections are established between the remotepractitioner devices and customer diagnostic centers, RPM server 24(and/or the CDC servers or customer diagnostic centers) may updatecertain of this information in real-time, such as by keeping track ofwhether each remote practitioners is logged in to the system and/orcurrently connected to a customer diagnostic center. Additionally, oralternatively, some or all of the practitioner data may be obtained,tracked and/or updated based on information received or accessed fromthird party sources, such as accessing a remote practitioner's workschedule (e.g., from a doctor's office or hospital associated with theremote practitioner) or accessing a scheduling or calendar applicationon the remote practitioner's device. In certain other embodiments, RPMserver 24 may use any other suitable means to obtain and update thepractitioner data.

In certain embodiments, the system for providing vision and/or eyehealth examinations may be provided, at least in part, by a centralizedcloud-based system. The cloud-based system may be accessible via a webbrowser (or other application) and may be compatible across all webplatforms and devices. Both remote practitioners and users at customerdiagnostic center 10 (and/or from other devices, such as a homecomputer) may login to the cloud-based system when utilizing the system.The cloud-based system may facilitate the exchange of audio/videostreams between remote practitioner devices 30 and customer diagnosticcenters 10, and may provide various interfaces for display on remotepractitioner devices 30 and devices located at customer diagnosticcenter 10. For example, interfaces may be provided via remotepractitioner device 30 for manipulating and controlling the equipment(e.g., the equipment illustrated in FIGS. 4 and 5) located at customerdiagnostic center 10, for transmitting customer evaluation data and/oreye health reports to customer diagnostic centers 10, for saving data toa server, for accessing customers' medical records, for communicatingwith customer diagnostic centers 10 (e.g., via instant messaging, voice,video or other means), and/or for any other features and functionalitiesrelated to administering an eye health or vision examination. Likewise,interfaces may also be provided to devices located at customerdiagnostic centers 10 for transmitting examination data to remotepractitioner devices 30, for saving data to a server, for accessingmedical records, for communicating with remote practitioner devices,and/or for any other features and functionalities related toadministering an eye health or vision examination.

Although a particular number of remote practitioner devices, CDC serversand customer diagnostic centers are shown in FIG. 2 for illustrativepurposes, it should be understood that the eye testing and evaluationsystem may include any number of these servers and devices. Similarly,while RPM server 24 and practitioner database server 26 are shown inFIG. 2, in certain embodiments, the functionality associated with RPMserver 24 and/or practitioner database server 26 may be any number ofservers. In certain other embodiments, some or all of the functionalityassociated with RPM server 24 and/or practitioner database server 26 maybe integrated with one or more of CDC servers 20A-20C and/or customerdiagnostic centers 10A-10E.

Customer Diagnostic Center

FIG. 3 is a block diagram illustrating a portion of the components of acustomer diagnostic center that may be used with the eye testing andevaluation system in accordance with certain embodiments. As mentionedabove, the customer diagnostic centers provided with the eye testing andevaluation system may be implemented through various types of structuresand physical arrangements. Likewise, the customer diagnostic centers mayinclude a wide range of components, such as general hardware components,mechanical devices, electronic equipment, computer hardware and softwareand any other suitable components for allowing customers to receive eyehealth examinations and/or vision examinations through the customerdiagnostic centers. It should be understood that the particularcomponents described below and/or illustrated in FIGS. 3-5 are intendedto be exemplary in nature, not exhaustive, and various other componentsmay be included with the customer diagnostic centers that are providedin connection with the eye testing and evaluation system, correspondingarrangements and systems and methods described herein.

As shown in FIG. 3, in certain embodiments, customer diagnostic center10, generally includes processor 110, memory 120, equipment controller130, vision examination system 140, eye health examination system 150,customer interface 160, onsite operator interface 170 and networkinterface 180. Processor 110 may be responsible for managing the overalloperation of customer diagnostic center 110 and/or controlling some orall of the components included therein. In certain embodiments,processor 110 may be a single processing unit, such as a CPU ormicrocontroller, or may be a computing device, such as a personalcomputer or workstation. In certain other embodiments, processor 110 maybe in the form of multiple processing units, computing devices or anycombination thereof. Memory 120 may be used to store and retrieve a widerange of data, such as software, programs and/or instructions executedby processor 110 (or other components) and/or data generated, receivedand used by various components of customer diagnostic center 10. Memory120 may include any known type of data storage device and/or media, suchas magnetic media, optical media, random access memory, read-onlymemory, data cache, etc., or any combination of one or more data storagedevices and media. In certain embodiments, memory 120 (or a portionthereof) may be integrated with one or more other components of customerdiagnostic center 10, such as processor 110.

Vision examination system 140 may include various ophthalmic devices,equipment, and instruments (e.g., refractors, phoropters, lensometers,etc.), and/or other associated systems, devices, components, and/orcomputer hardware, software and data that allow customers to receivevision examinations at customer diagnostic center 10. In certain ofthese embodiments, vision examination system 140 may be used inconnection with administering a number of tests and procedures tocustomers and measuring, capturing and/or generating various dataassociated with determining the customers' visual acuity and/orevaluating certain other aspects of the customers' vision. Similarly,eye health examination system 150 may include various ophthalmicequipment (e.g., tonometers, digital imagers, biomicroscopes, etc.)and/or other associated components that allow customers to receive eyehealth examinations at customer diagnostic center 10. In certain ofthese embodiments, eye health examination system 150 may be used inconnection with administering a number of tests and procedures tocustomers and measuring, capturing and/or generating various dataassociated with evaluating the customers' eye health.

Although vision examination system 140 and eye health examination system150 are shown in FIG. 3, it should be understood that, in certainembodiments, this may be a logical rather than a physical distinction.In other words, in certain of these embodiments, some or all of theophthalmic equipment and associated components may be used in connectionwith both vision examinations and eye health examinations. Examples ofthe types of ophthalmic devices, equipment and instruments andassociated components that may be included in vision examination system140 and eye health examination system 150, along with various tests andprocedures that may be administered to customers using such equipment,are further illustrated and described below in connection with FIGS. 4and 5.

Equipment controller 130 may be responsible for controlling theoperation of vision examination system 140 and/or eye health examinationsystem 150. In certain embodiments, this may include controlling some orall of the ophthalmic equipment and associated components in a number ofways, such as turning equipment on and off, initializing and setting upthe equipment, moving and positioning the equipment, and/or instructingthe equipment to perform various operations and procedures. In certainembodiments, equipment controller 130 may include a single processingunit, microcontroller, or computing device that controls some or all ofthe ophthalmic equipment and associated components of vision examinationsystem 140 and/or eye health examination system 150. In certain otherembodiments, equipment controller 130 may include a number of processingunits, microcontrollers and/or computing devices, each of which isresponsible for controlling one or more of the ophthalmic devices,instruments, equipment, and/or associated components. In yet otherembodiments, some or all of the functionality associated with equipmentcontroller 130 may be integrated with various other components, such asprocessor 110 or onsite operator interface 170. For example, in certainof these embodiments, equipment controller 130 and/or processor 110 maybe in the form of (or include) a personal computer, workstation, orsimilar computing device, which is connected (physically and/orwirelessly) to some or all of the ophthalmic equipment and associatedcomponents included in vision examination system 140 and/or eye healthexamination system 150.

According to certain embodiments, equipment controller 130 may includeand execute various software, programs and/or instructions associatedwith controlling the operation of the ophthalmic equipment andassociated components. For example, equipment controller 130 may run oneor more programs that include instructions for setting up the equipmentand/or using the equipment to administer a number of tests andprocedures in response to a customer requesting a vision examinationand/or eye health examination through customer diagnostic center 10. Incertain of these embodiments, equipment controller 130 may retrieve thesoftware, programs and/or instructions from memory (such as memory 120)execute the programs on an as-needed basis or when instructed to do soby processor 110. In certain embodiments, such as where the ophthalmicequipment and/or test administration can be monitored and controlled byvarious individuals (e.g., a remote practitioner, off-site technician,and/or on-site operator) equipment controller 130 may also (or instead)receive instructions, or execute instructions based on input received,from various other components of customer diagnostic center 10. Incertain of these embodiments, for example, equipment controller 130 mayreceive instructions or input from a remote practitioner and/or offsitetechnician (e.g., remote practitioner's assistant, remote equipmentoperator) via network interface 180, of from an on-site operator ortechnician via on-site operator interface 170.

As shown in FIG. 3, in certain embodiments customer diagnostic center 10may include on-site operator interface 170, which may allow an operator,technician, examination assistant, or any other suitable individual, whois at the same location as the customer diagnostic center to controlcertain aspects of the customer diagnostic center. In certainembodiments, for example, on-site operator interface 170 may allow theon-site technician to control and/or monitor some or all of theophthalmic equipment and associated components included with visionexamination system 140 and eye health examination system 150 and/or thetests and procedures administered to customers using the equipment. Incertain of these embodiments, the on-site technician may control,modify, and customize the equipment, tests and/or information output tocustomers during the tests for a particular customer, such as based onone or more responses or selections provided by the customer or inresponse to various data, measurements and results obtained through thetests. As another example, on-site operator interface 170 may enable theon-site technician to control and monitor other operations of customerdiagnostic center 10, such as to assist customers with creating anaccount, accessing and updating prior test reports and customer data,forwarding information to third parties (e.g., sending test reports oroptical prescriptions to an external practitioner or lens lab), and/orordering and purchasing eye care and vision related products andservices from an online retailer.

In certain embodiments, on-site operator interface 170 may includevarious input/output devices and components that enable an on-sitetechnician to monitor and control the operations of customer diagnosticcenter 10. In certain of these embodiments, for example, on-siteoperator interface 170 may include one or more displays, touch screens,speakers, voice recognition systems, keyboards, touch pads, mice,joysticks, microphones, and/or any other suitable input/output devicesand components for displaying or otherwise outputting information to theon-site technician (e.g., equipment status, examination data andresults, customer inputs and responses, etc.) and/or receivingselections and inputs from the on-site technician (e.g., commands,instructions, data to be output to the customer, etc.). In certainembodiments, such as where equipment controller 130 and/or processor 110are in the form of (or include) a personal computer or workstation,on-site operator interface 170 may comprise various standardinput/output components and peripheral devices that are integrated with(or connected to) the personal computer (e.g., monitor, keyboard, mouse,etc.). On-site operator interface 170 may also include computersoftware, applications and/or programs that assist the on-sitetechnician with the process of monitoring and controlling the operationsof the customer diagnostic center. For example, on-site operatorinterface 170 may provide one or more applications that allow on-sitetechnicians to make various selections, input data and commands, and/orview information pertaining to certain components of the customerdiagnostic center through a graphical user interface.

Customer interface 160 may be used to display information and data to,and receive various inputs, selections, and responses from thecustomers. Like on-site operator interface 170, customer interface 160may include any suitable input/output devices and components, (e.g.touch-sensitive and/or other types of display screens, microphones,speakers, keyboards, mice, etc.) that enable customers to, and assistcustomer with, requesting and receiving vision examinations and/or eyehealth examination and accessing various other features andfunctionality provided through customer diagnostic center 10.

For example, in connection with a customer accessing customer diagnosticcenter 10, customer interface 160 may display one or more questions,forms, options, prompts or the like that allow the user to access, view,input, modify, and/or update various information associated with thecustomer (e.g., user login information, account data, customer data,prior examination reports, results and data, etc.). Similarly, incertain embodiments, customer interface 160 may present customers withvarious options concerning the services that can be obtained throughcustomer diagnostic center. In certain of these embodiments, customersmay be able to select an option to receive a vision examination, eyehealth examination or both. In certain other embodiments, customers maybe able to choose from one or more predefined vision examination and/oreye health examination services (e.g., services associated withdifferent levels, costs, time requirements) and/or create a customizedvision examination and/or eye health examination by selecting one ormore specific tests and procedures to be included in the desiredservice. In certain embodiments, the customer interface 160 may displayoptions for transmitting a request for selecting a practitioner toadminister an vision or eye health examination. In certain embodiments,the customer interface 160 may display options for selecting apractitioner for administering an vision or eye health examination andthe request transmitted from the customer diagnostic center may identifyone or more practitioners. In certain embodiments, a request for anvision or eye health examination may be received at a server and theserver may select one or more practitioners to receive the request.

As another example, in connection with administering various eye healthand vision tests to a customer, customer interface 160 may displayvarious information to the customer, such as data used to perform thetests (e.g. eye-charts, testing images and graphics), data associatedwith requesting the customer to provide certain responses, selectionsand inputs (e.g., test questions, forms, etc.), and/or data pertainingto testing instructions or directions (e.g., instructing the customer tostand, sit, or assume a particular position, blink, look in a certaindirection, etc.). In turn, customer interface 160 may receive variousdata from the customer during the tests, such as responses to testquestions.

As yet another example, after a customer has received an eye healthexamination and/or vision examination through customer diagnostic center10 (or another customer diagnostic center), customer interface 160 maydisplay various information pertaining to the tests, such as results,diagnoses, recommendations and other data that is automaticallygenerated by customer diagnostic center 10 (and/or a CDC serverassociated therewith), or data received from a remote practitioner(e.g., eye-health reports, optical and other prescriptions, diagnoses,recommendations, referrals). In addition, as discussed in more detailbelow, a wide variety of data and information may also be displayed toand received from customers through customer interface 160 in connectionwith numerous other features and functionality, such as paying forservices received through the customer diagnostic centers, requestingdata to be forwarded to one or more third parties, viewing, ordering andpurchasing eye-care and vision products and services, and/orcommunicating with remote practitioners and other third parties.

In certain embodiments, customer interface 160 may include varioussoftware, applications and programs for managing the output ofinformation to customers and/or assisting customers with the process ofinputting and providing data, responses, etc. In certain of theseembodiments, these applications may provide customers with auser-friendly graphical user interface that allows the customers toaccess and view information, input text and other data, and makeselections, such as through a touch screen, keyboard, mouse or the like.

According to certain embodiments, customer interface 160 may include anaudio response system, which may comprise and utilize various systems,devices, and software, such as speakers, microphones, voice recognitionsoftware, text-to-voice software, etc. In certain of these embodiments,the audio response system may be used to output various information anddata to and/or receive various inputs, selections and data from thecustomers in the form of voice and/or other suitable audio data. Incertain of these embodiments, the audio response system may be utilizedin addition to (or instead of) outputting and receiving some or all ofthe data through other mechanisms, such as displays, keyboards, etc. Forexample, the audio response system may be used in connection with theadministration of one or more eye health and/or vision tests, such as toask the customer questions, receive responses and selections from thecustomer, and/or provide instructions and directions to the customer. Incertain of these embodiments, the questions or other audio outputs maybe based on a stored set of predefined questions and/or may be selectedor determined based on the customer's responses to previous questions orthe measurements or results of prior tests or procedures administered tothe customer.

In certain embodiments, customer diagnostic center 10 may includenetwork interface 180, as shown in FIG. 3. Network interface 180 mayinclude any known networking devices, computer hardware and software,and/or associated systems and components, that enable customerdiagnostic center 10 to send and receive data via one or more networks.In certain of embodiments, network interface 180 may provide interfacesthat allow customer diagnostic center 10 to communicate with (and/orconnect to) various other systems and devices (e.g., CDC servers, remotepractitioner devices, third party retailer systems, etc.) over a widerange of networks (e.g., network 50). In certain of these embodiments,network interface 180 may also (or alternatively) be responsible forfacilitating, controlling and/or managing some or all of thecommunications. For example, network interface 180 may facilitate and/ormanage the communication of various data to and from CDC servers (e.g.,customer data, testing data and programs, software and firmware updates,etc.), and remote practitioner devices (e.g., customer data, customerexamination data, customer evaluation data, etc.).

According to certain embodiments, network interface 180 may includevarious systems, software and other components that allow for theencryption and encoding of some or all of the communications sent fromthe customer diagnostic center to be encrypted or encoded prior totransmission (as well as the decryption and decoding of communicationsreceived by the customer diagnostic center). For example, customerdiagnostic center 10 may encrypt and/or encode all transmissions thatinclude medical data for the customers (e.g., customer examination data,prior test results, etc.), or may encrypt and/or encode alltransmissions having any data that is associated with the customers. Incertain of these embodiments, the data and/or communications may beencrypted and/or encoded using any know methods and mechanisms.

Although FIG. 3 illustrates a exemplary portion of the systems, devices,and components that may be included in customer diagnostic center 10, incertain embodiments some or all of the customer diagnostic centersprovided through the eye system may include various other systems,devices, and components (not shown in FIG. 3). For example, the customerdiagnostic centers may include one or more recording devices, systems,and/or associated software (e.g., cameras, video cameras, audiorecorders, etc.) that enable the customer diagnostic centers to captureand record various data associated with the administration of the testsand procedures to customers. In certain embodiments, such as where thecustomer diagnostic centers communicate with a remote practitionerand/or off-site technician, this data may be sent to these individualsalong with (or instead of) customer data and/or customer examinationdata, such as to allow the remote practitioner to view the customers,view or hear responses from the customers, and/or to determine whethercertain equipment was setup and operated appropriately and whether oneor more tests were administered properly. In certain of theseembodiments, such as where a real-time connection is established betweenthe customer diagnostic centers and the remote practitioner devices, therecording system may allow the customer to interact with the remotepractitioner in real-time (e.g., through an audio/video conferencingsystem or the like).

As another example, the customer diagnostic centers may include variouspayment related devices, systems, and/or software (e.g., credit/debitcard readers, devices for depositing cash or checks, etc.) that allowthe customer diagnostic center to receive payments from customers, suchas in connection with providing customers with eye health examinations,vision examinations, and/or other services (e.g., ordering products andservices from third parties). As yet another example, the customerdiagnostic centers may include a number of other devices and systems forproviding information to customers, such as printers, and/or forallowing customers to upload and input information, such as scanners,card readers, USB key readers, etc.

Additionally, some or all of the components shown in FIG. 3, may beomitted from customer diagnostic centers provided through the eyetesting and evaluation system, or may be replaced with one or more othercomponents. For example, in certain embodiments, some or all of thecustomer diagnostic centers may be implemented without the use of anon-site operator interface, and/or may include only one of visionexamination system 150 or eye health examination system 140.

Vision Examination System

FIG. 4 is a block diagram illustrating a portion of a customerdiagnostic center having a vision examination system in accordance withcertain embodiments. As discussed above, in certain embodiments, some orall of the customer diagnostic centers provided with the eye testing andevaluation system may include a vision examination system. The visionexamination system may comprise various ophthalmic devices, equipmentand instruments, and other general hardware, mechanical and electronicdevices and/or computer software and hardware that is utilized by thecustomer diagnostic center to provide vision examinations to customers.For example, as shown in FIG. 4, vision examination system 140 mayinclude auto-phoropter 141, lens houser 142, auto refractor 143,lensometer 144, eye chart 145, and vision examination controller 148.

In certain embodiments, auto-phoropter 141 may comprise any suitabletype of phoropter and/or other similar device (or a number of suchphoropters and devices) that can be used to present powered lenses infront of a customer's eyes. Lens houser 142 may include one or moredevices that are used to house and maintain a number of powered lensesand/or allow the lenses that are presented through auto-phoropter 141 tobe switched in and out. In certain embodiments, lens houser 142 includesa wide range of powered lenses having different sphere, cylinder and/oraxis values. Although, auto-phoropter 141 and lens houser 142 are shownas separate components in FIG. 4, in certain other embodiments, lenshouser 142 (or a portion thereof) may be integrated with auto-phoropter141.

Auto-refractor 143 may include one or more suitable types of refractorsand/or similar devices that can be used to measure the refractive errorof a customer's eyes. In certain of these embodiments, auto-refractor143 may allow the system to determine approximate objective opticalerror specifications for sphere, cylinder and axis for one or both ofthe customer's eyes and/or measure curvatures in the steepest andflattest meridians of the corneas. In certain embodiments, visionexamination system 140 may include an auto-keratometer, which may beintegrated with auto-refractor 143, for measuring “K readings” that maybe used to determine back or base curvature of a customer's lenses.Lensometer 144 may comprise one or more suitable types of lensometerand/or similar devices that can be used to measure and determine thepower of optical lenses that are included in a pair of eye-glasses orcontact lenses (e.g., the customer's current glasses). Eye chart 145 maybe in the form of one or more charts, images, or the like, that can bepresented to customers during various vision examination tests, such asto aid in determining the customer's visual acuity. In certain of theseembodiments, eye chart 145 may include one or more physical eye chartsand/or virtual eye charts (e.g., charts or images that are displayed ona computer screen or electronic display).

As shown in FIG. 4, in certain embodiments, vision examination system140 may also include vision examination controller 148, which maycomprise one or more processing units, microcontrollers, computingdevices, hardware and software, and/or mechanical and electrical devicesand components that control the operations of the vision examinationequipment. In certain embodiments, vision examination controller 148 maybe connected to and/or communicate with equipment controller 130 toallow the vision examination equipment to be monitored and/or controlledby the customer diagnostic center and/or one or more individuals (e.g.,on-site operator). In certain other embodiments, vision examinationcontroller 148 (or a portion thereof) may be integrated with equipmentcontroller 130 and/or the vision examination equipment (e.g.,auto-phoropter 141, lensometer 144, etc.).

In certain embodiments, some or all of these (and other) components maybe used by the customer diagnostic center in connection withadministering a variety of tests and procedures to customers, such as inorder to measure, capture and/or record data pertaining to a customers'visual acuity and/or visual ability. For example, some or all of thesecomponents may be used in order to perform an automated refractionprocess that allows the refractive error of a customer's eyes to bedetermined. The following description is intended to demonstrate thetype of steps and operations that may be included in an exemplaryautomated refraction process performed by a customer diagnostic centerin accordance with certain embodiments.

In response to a customer requesting a vision examination, the customerdiagnostic center may determine a preliminary refractive error or errorrange for the customer's eyes. In certain embodiments, the preliminaryerror may be determined based on various data associated with thecustomer, such as prescriptions or refractive errors associated with oneor more prior vision examinations received by the customer (e.g.,through a customer diagnostic center and/or from various practitioners)that is retrieved from customer data (e.g., stored in local memory or ata CDC server or database server). Alternatively, or in addition, thecustomer diagnostic center may use lensometer 144 to determine thepreliminary refractive error by measuring the power of the lenses in acurrent pair of eyeglasses or contact lenses provided by the customer.In certain of these embodiments, the preliminary refractive error may beused in the automated refraction process in various manners, such as todetermine a starting point for other tests or calculations or to confirmor check that the process was performed properly (e.g., to check thatthe ultimate determination for the refractive error does not conflictwith or seem highly improbably in light of the customer's priorrefractive error). The customer diagnostic center may also (or instead)measure the refractive error of the customer's eyes using auto-refractor143.

The customer diagnostic center may then use auto-phoropter 141, lenshouser 142 and/or eye chart 145 to administer an interactive refractiontest to the customer. In certain embodiments, this may include aniterative process in which powered lenses are placed in front of thecustomer's eyes using auto-phoropter 141 and/or lens houser 142,questions are presented to and responses are received from the customerusing the customer interface (e.g., through the audio response system),and based on the customer's responses, the powered lenses are switchedwith lenses having a different power, and so on. The questions mayinclude asking the customer to read information displayed on eye chart145 and/or asking the customer whether the displayed information appearsclearer or less clear with the current powered lenses. In certain ofthese embodiments, the questions may be retrieved from a predefined setof stored questions and/or based on the customer's responses to previousquestions. This iterative process may continue until one or moreconditions or criteria are met, such as receiving a particularcombination of responses from the customer, or determining thatsufficient data has been acquired through the test.

In certain embodiments, after performing these tests and measurements(or at one or more points during the process) the customer diagnosticcenter may record and/or store various types of data, such as thequestions presented to and responses or inputs received from thecustomer, the tests, operations and steps performed, the results of themeasurements, calculations performed, etc. In turn, some or all of thisdata may be stored locally and/or sent to a CDC server to update thecustomer data and other information associated with the customer. Thecustomer diagnostic center may then determine an updated refractiveerror for the customer's eyes, such as by making various calculationsand applying one or more predefined algorithms to the examination dataand/or other data (e.g., customer data). In certain embodiments thecustomer diagnostic center may package and/or format some or all of theexamination data and customer data, together with the final refractiveerror and other information (e.g., potential disorders, defects orconditions detected by the customer diagnostic center based on theexamination data), and send the packaged data to a remote practitionerfor review and confirmation. In response, the customer diagnostic centermay receive customer evaluation data (e.g., revised refractive error,optical prescription, recommendations, referrals to see otherpractitioners, etc.) from the remote practitioner.

In certain other embodiments, the customer diagnostic center mayestablish a connection with the remote practitioner prior to, during, orafter performing the automated refraction procedure, such as to allowthe remote practitioner to monitor and control the tests, view andinteract with the customer, review and analyze the examination data,and/or provide the evaluation data in real-time. In yet otherembodiments, the customer diagnostic center may automatically generatecustomer evaluation data based on the updated refractive error,examination data and/or customer data. After generating or receiving thecustomer evaluation data, the customer diagnostic center may provide thecustomer evaluation data (or a portion of it) to the customer, such asby displaying information to the customer and/or providing the customerwith one or more printed documents (e.g., an optical prescription) atthe customer diagnostic center, or sending information to the customer(e.g., via e-mail).

As can be seen from the foregoing, the automated refraction procedureperformed through the customer diagnostic center may include both anobjective portion (e.g., using auto-refractor 143 to measure thecustomer's objective refractive error and/or lensometer 144 to measurethe power of the customer's current lenses), and a subjective portion(e.g., using auto-phoropter 141, lens houser 142, eye chart 145 and/oran automated voice response system to present powered lenses in front ofthe customer's eyes and ask the customer questions and receivesubjective responses from the customer pertaining to the customer'sperceived visual acuity with such powered lenses). In a similar manner,various other vision examination and/or eye health tests and proceduresperformed by the customer diagnostic center may include both objectiveand subjective components. One important benefit to using these types oftests is that the accuracy of the tests and the corresponding results isoften significantly higher as compared to similar tests that onlyutilize an objective or subjective process.

The exemplary automated refraction process discussed above is intendedto be illustrative, not limiting, and it should be understood that, incertain other embodiments, one or more of the described steps oroperations could be removed, reordered, or modified, or could bereplaced with one or more other steps or operations, and various othersteps and operations may be added to the process. Also, the visionexamination system illustrated in FIG. 4 may be used by the customerdiagnostic center to perform various other tests and proceduresassociated with the examination of a customer's vision. Likewise, thevision examination system may be modified, such as by omitting, updatingor replacing one or more of the components shown in FIG. 4 and/orincluding other ophthalmic equipment, devices, instruments, and/or otherassociated components, in order to incorporate new or update existingvision examination equipment, tests and procedures.

For example, vision examination system 140 may include an electronicvisual acuity monitor for allowing the system to perform various testsassociated with measuring a customer's visual acuity at longerdistances. In certain embodiments, the electronic visual acuity monitormay be used to determine the size of objects at specific distances thatare visually perceptible to a customer (e.g., 20/20 or 20/30 sizeletters or other object). In certain of these embodiments, theelectronic visual acuity monitor (or a portion of it) may be integratedwith eye chart 145, such as in the form of a Snellen ‘E’ chart in aself-lit visual acuity monitor. In certain embodiments, the electronicvisual acuity monitor may be used to administer various tests to measuredigital visual acuity data for a customer with and/or without lenses atvarious distances, based on subjective responses and inputs receivedfrom the customer, which can be compared to certain measurementstandards. In certain of these embodiments, the measurements and resultsof such tests may allow the system to assess changes in the customer'svision, such as in response to a new set of lenses or treatmentsreceived by the customer (e.g., medicine or surgery).

Eye Health Examination System

FIG. 5 is a block diagram illustrating a portion of a customerdiagnostic center having an eye health examination system in accordancewith certain embodiments. As discussed above, in certain embodiments,some or all of the customer diagnostic centers provided with the eyetesting and evaluation system may include an eye health examinationsystem. The eye health examination system may comprise variousophthalmic devices, equipment and instruments, and other generalhardware, mechanical and electronic devices and/or computer software andhardware that is utilized by the customer diagnostic center to provideeye health examinations to customers. For example, as shown in FIG. 5,eye health examination system 150 may include digital imager 151,biomicroscope 152, retinal camera 153, tonometer 154, visual fieldinstruments 155, and eye health examination controller 158.

In certain embodiments, digital imager 151 may comprise any suitabletype of digital imaging device, such as a camera, video-camera, sonarimager, infrared imager, or other similar digital imager (or a number ofsuch devices) that can be used to capture, record and/or generatedigital images of a customer. For example, digital imager 151 may beused to obtain full facial images of a customer, and/or variousproportionate, to-scale, images of the customer's eyes, pupils, face, orhead (e.g., a full facial image). Biomicroscope 152 may be in the formof any suitable type of microscope or microscopes that are used tomagnify the view of the anterior portion of a person's eyes (e.g., thefirst third of a person's total eye length). In certain embodiments,biomicroscope 152 and/or digital imager 151 may be used to detect, andcapture images related to, various tissue enhancements (e.g. from thetear layer, cornea, aqueous/anterior chamber, lens, and/or posteriorchamber).

In certain embodiments, retinal camera 153 may comprise any suitabletype of camera or other like device that allows for enhanced viewingand/or digital imaging of the rear portion of a person's eyes (e.g., theback two third's of a person's total eye length). For example, retinalcamera 153 may be used to detect, and capture images related to, thevitreous, choroids, retina, macula, and/or optic nerve of a person'seyes. A tonometer 154 may also be used. Tonometer 154 may include anysuitable device or device that can be used to measure the intraocularpressure of a person's eyes, such as to detect, diagnose, and/orevaluate the possibility of glaucoma. In certain of these embodiments,for example, tonometer 154 may allow intraocular pressure to bedetermined in millimeters of mercury (mmHG), such as by detecting thedegree of indentation (e.g., resistance) of a probe at a ninety degreeangle flat to the center of a person's cornea and using this measurementto calculate mmHG based on one or more predefined formulas.

Eye health examination system 150 may also include various visual fieldinstruments, such as visual field instruments 155 illustrated in FIG. 5.In certain embodiments, visual field instruments 155 may comprise one ormore instruments and devices that can be used to detect and measurevisual sensitivity and/or acuity in a person's peripheral view (e.g.,things surrounding an object upon which a person's vision is primarilyfixed or focused). For example, in certain of these embodiments, visualfield instruments 155 may be used to flash various visual stimuli ofdifferent light-candle strengths in a customer's periphery while thecustomer's vision is focused on an object that is straight-ahead. Inturn, such tests can determine the existence of various defective fieldsof vision, such as patterns of non-discernable vision within aworld-view having four, equal and symmetric quadrants (e.g., a person'sblind spot, where there are no rods and cones), which can be used todetect, diagnose, and/or evaluate certain conditions and disorders(e.g., advancing glaucoma, detached retina, tumors, diabeticretinopathy, or retinitis pigmentosa).

As shown in FIG. 5, in certain embodiments, eye health examinationsystem 150 may also include eye health examination controller 158, whichmay comprise one or more processing units, microcontrollers, computingdevices, hardware and software, and/or mechanical and electrical devicesand components that control the operations of the eye health examinationequipment. In certain embodiments, eye health examination controller 158may be connected to and/or communicate with equipment controller 130 toallow the eye health examination equipment to be monitored and/orcontrolled by the customer diagnostic center and/or one or moreindividuals (e.g., on-site operator). In certain other embodiments, eyehealth examination controller 158 (or a portion thereof) may beintegrated with equipment controller 130 and/or the eye healthexamination equipment (e.g., digital imager 151, tonometer 154, etc.).

In certain embodiments, some or all of these (and other) components maybe used by the customer diagnostic center in connection withadministering a variety of tests and procedures to customers associatedwith evaluating the customers' eye health. For example, the customerdiagnostic center may use some or all of the eye health examinationequipment to measure, capture and record customer examination datapertaining to a customer's eye health, process, analyze and evaluate thecustomer examination data, package and deliver the customer examinationdata to a remote practitioner for review, receive customer evaluationdata from the remote practitioner and/or provide an eye health report tothe customer, in a similar manner to the automate refraction processdescribed above.

The following provides certain examples of ophthalmic equipment,devices, instruments, and components, as well as tests and proceduresthat may be incorporated with the eye health examination system andoffered to customers through the customer diagnostic centers inaccordance with certain embodiments. It should be understood that theparticular equipment and tests described below are intended to beexemplary in nature, not exhaustive, and various other equipment andtests may be used in connection with the eye health examination system,corresponding arrangements and systems, devices and methods describedherein. For example, like the vision examination equipment discussedabove, the eye health examination system may be modified, such as byomitting, updating or replacing one or more of the components shown inFIG. 5 and/or including numerous other types of ophthalmic equipment,devices, instruments, and/or other associated components. As anotherexample, the eye health examination system may be periodically updatedand/or expanded in order to incorporate new or modify existing eye heathexamination equipment, tests and procedures, thereby providing customerswith a wide range of the most up-to-date equipment, tests and proceduresassociated with examining eye health.

In certain embodiments, the eye health examination system may includeone or more of the following ophthalmic devices, instruments andequipment and/or may utilize one or more of the following tests andprocedures in connection with providing customers with eye healthexaminations through the customer diagnostic centers:

-   -   Pachymeters/Tomographers—one or more pachymeters, tomographers,        and similar devices and instruments may be included, such as an        ultrasound pachymeter, optical coherence tomographer (OCT),        optical coherence pachymeter (OCP), computerized corneal        topographer, corneal waveform device (CWF), anterior segment        optical coherence tomographer and/or ultrasound biomicroscope.        In certain embodiments, these and other devices may be used for        taking measurements and performing various tests associated with        the cornea, optic nerve, and/or retina and examining the        anatomic relationship between the lens, iris and cornea (e.g.,        anterior chamber depth and structures posterior to the iris,        position of ciliary body, or cyclodialysis cleft). Ultrasound        pachymetry may be used to non-invasively measure corneal        thickness by confocal microscopy, ultrasound, optical biometry        with a camera, or an OCT and online OCP. Alternatively (or        additionally), an ultrasonic transducer may be utilized to touch        the cornea and/or a CWF may be used to capture an ultra-high        definition echogram. OCT may be used for low coherence        interferometry to evaluate optic nerve and retinal nerve fiber        layer (RNFL) thickness (e.g., measured in the peripapillary        region with circular scans centered around the optic nerve head        (ONH)). In certain of these embodiments, RNFL thickness        measurements may be shown in a TSNIT orientation and compared to        age matched controlled individuals. In certain embodiments,        these devices and tests may allow the system to monitor changes        in a customer's corneas, intraocular pressure, ONH and retina,        evaluate changes in eye tissues, and/or determine endothelial        cell counts and detect corneal irregularities. In certain of        these embodiments, the these devices and tests may be used to        confirm diagnoses and monitor outcomes after various types of        interventions (e.g., to detect subtle wrinkling of chorioretinal        folds in posterior pole that are difficult to assess with direct        or indirect ophthalmoscopy).    -   Potential Acuity Meter (PAM)—a PAM or similar device may be        included for use in determining visual potential. For example,        in certain embodiments, a PAM having an integrated slit lamp may        be used to align and focus microscopic white dots to be viewed        by a customer. As another example, the device may be used to        focus an acuity chart on a customer's retina to remove        lenticular affects and determine macular vision potential.    -   Scheimflug Photography/Tomography—a Scheimpflug camera or        similar device may be included for performing Scheimpflug        photography and/or tomography procedures and the like for        evaluating a customer's cornea and other portions of the front        of the eye. In certain embodiments, these devices may provide        digital images of the anterior chamber angle. In certain of        these embodiments, rotating versions of the devices may be        included that provide three-dimensional digital imagery. Various        software and programs may be utilized to measure specific        parameters of the angles. In certain embodiments, these devices        and tests may allow the system to detect, diagnose and/or        analyze certain types of glaucoma (e.g., narrow/closed angle        glaucoma).    -   Scanning Laser Polarimetry (SLP)—SLP may be used to monitor the        RNFL and measure peripapillary RNFL thickness, such as by        performing laser scans of the posterior retina and measuring        birefringent properties of neurotubules contained within        ganglion cell axons. In certain of these embodiments, the RNFL        thickness in a circular area around the optic nerve may be        determined and/or compared to the “double hump” generally        observed in normal individuals, in which the superior and        inferior poles have the greatest RNFL thickness as opposed to        the nasal and temporal poles. In certain embodiments, a GDx        nerve fiber analyzer with variable corneal compensation may be        utilized to account for individualized corneal differences.    -   Heidelberg Retina Tomography (HRT)—HRT may be used to measure        optic disc tomography using lasers to scan multiple cross        sections images to create and analyze a three-dimensional        representation of the optic nerve. In certain embodiments, the        3-D representation may be used to assess thickness, surfaces of        the optic cup, calculation of cup-to-disc ratio, rim area, and        other optic disc parameters. In certain of these embodiments,        HRT may be used to evaluate and monitor glaucoma.    -   Fundus/Retinal Cameras—one or more fundus cameras and/or retinal        cameras may be included, such as mydriatic/non-mydriatic retinal        cameras, hybrid digital mydriatic/non-mydriatic retinal cameras,        non-mydriatic fundus cameras, autoflourescense cameras. In        certain embodiments, these and other devices may be used for        fundus photography with and/or without the pupils dilated to        create photographs of the interior surface of the eye, including        the retina, optic disc, macula, and posterior pole. In certain        of these embodiments, these images may be used to evaluate the        posterior of the eye and diseases or abnormalities of the        retina, choroid, vitreous, optic disc, macula and posterior        pole.    -   Fluorescein Angiography (IVFA)—IVFA and/or phase contrast        microscopy may be used to diagnose, evaluate, monitor and/or        treat retinal abnormalities (e.g., hypertensive and diabetic        retinopathies).    -   Indocyanine Green Angiography (ICG)—ICG may be used to detect        certain abnormalities or diseases not detected through IVFA.    -   Cachet-Bonnet Anesthesiometer—an anesthesiometer, such as a        Cachet-Bonnet anesthesiometer may be included, such as to        measure corneal sensitivity and, in turn corneal diseases and        abnormalities.    -   Orbscan/Optical Biometer—an Orbscan or optical biometer may be        included for A-scan ultrasound biometry. In certain embodiments,        measurements are taken along a visual axis over the curvature of        the cornea which may provide data on the length of the eye        and/or intraocular lens power. In certain of these embodiments,        the measurements may be used to detect common sight disorders.    -   Tonometer—one or more tonometers or the like may be included,        such as an Applation Goldman Tonometer, Non-Applanation        Tonometer, Air-Puff Tonometer, Ocular Response Analyzer,        Non-Contact Tonometer, Indentation Shiotz, Tono-Pen, Rebound        Tonometer, and/or Pascal Dynamic Contor. In certain embodiments,        these and other devices may be used for measuring intraocular        fluid eye pressure or corneal visco-elasticity, such as to        monitor the integrity of the cornea and/or detect certain        pathologies, such as keratoconus and glaucoma.

Additionally, in certain embodiments, the eye health examination systemmay include numerous other types of ophthalmic devices, instruments andequipment and/or may utilize numerous other types tests and proceduresin connection with providing customers with eye health examinationsthrough the customer diagnostic centers, including brightness acuitytester, macular photostress test, function vision analyzer, stereopsistesting, color testing (e.g., Ishihara or Farnsworth lantern), pin holepotential acuity testing, contrast sensitivity testing, wavefrontaberrometer, refractive power/corneal analyzer, slit lamp biomicroscopy,hand-held slit lamp, the Seidel test with slit lamp, the Van Herick testwith slit lamp, Goldman tonometer with slit lamp, oblique flashlighttest, swinging flashlight test, exophthalmometer, ERG and mERG, visuallyevoked response test, electro-oculogram, cover test, ocular motility,Amsler grid, perimeters (e.g., automated static threshold perimeter),Swedish interactive threshold algorithm test, Esterman test on Humphreyperimeter, short-wavelength automated perimetry, frequency doublingtechnology, Foresee preferential hyperacuity perimeter, pupilometer forpupilar distance, pupilometer for visual stimuli, ophthalmoscope,direct/indirect ophthalmoscope, confocal laser ophthalmoscope,wide-angle twin magnification ophthalmoscope, retinoscope, Schirmertest, dry eye/tear film dysfunction test, radiuscope, opticalmicrospherometer, progressive add lens finder, operating microscope,gonioscope with slit lamp, direct/indirect goniolens, magnetic resonanceimaging, nuclear magnetic resonance imaging, magnetic resonancetomography, computed tomography, computed axial tomography.

Varying Levels of Automation and Assistance

As mentioned above, the eye testing and evaluation system may beimplemented using different levels of automation and/or different typesof assistance from on-site and/or remote individuals. The followingdescribes a number of exemplary implementations having varying degreesof assistance and automation, in accordance with certain embodiments.

In certain embodiments, for example, the system (or a portion thereof)may be configured to be fully automated, thereby allowing customers toobtain vision examinations and/or eye health examinations at a customerdiagnostic center with no assistance from others. In certain of theseembodiments, the customer diagnostic centers may utilize and executesoftware applications, programs and routines that are designed to obtainvarious information from the customers through the customer interface(e.g., customer data) and determine one or more vision examinationand/or eye health examination tests and procedures to administer to thecustomers (e.g., based on the customers' data and/or selections receivedfrom the customer regarding desired services). Likewise, the customerdiagnostic centers may utilize and execute software in connection withadministering one or more tests to the customer, such as programs thatenable the customer diagnostic centers to control and operate theophthalmic equipment, devices and related components, outputinstructions, questions, testing data and other information tocustomers, and/or receive and record responses and inputs from thecustomers, measurements, readings, and other data resulting fromadministering the tests and procedures. In turn, after administering thetests and procedures (or during such administration), the customerdiagnostic centers may process and analyze the data captured andrecorded through the tests, and/or other data (e.g., customer data),using various algorithms, metrics and software in order to automaticallyevaluate the customers' vision and/or eye health. In certain of theseembodiments, the customer diagnostic centers may also utilize andexecute various software for auto-generating one or more reports,documents, and the like pertaining to the customers' vision and/or eyehealth (e.g., eye-health reports, prescriptions, recommendations,referrals, etc.) that can be output and/or provided to the customers.

In certain embodiments, the system (or a portion thereof) may beconfigured to enable on-site operators (e.g., operators, technicians, orassistants at the sites where the customer diagnostic centers arelocated) to facilitate and assist customers with one or more aspects ofthe vision examinations, eye-health examinations, and/or other services,features and functionality provided through the customer diagnosticcenters. In certain of these embodiments, for example, the on-siteoperators may simply assist customers with one or more processesassociated with the use of the customer diagnostic centers, such ascreating an account, choosing desired services, printing out an eyehealth or vision report, forwarding data to third parties, etc. Asanother example, the on-site operators may assist and guide customersduring the administration of various tests and procedures, such as byhelping customers assume the required positions and answer or respond tocertain questions or other data output during the tests. In certain ofthese embodiments, the on-site operators may provide assistance tocustomers on an as-needed or as-desired basis, such as in response to acustomer selecting an option or otherwise indicating a desire foron-site help.

In certain of these embodiments, the on-site operators may monitorand/or control the ophthalmic equipment and devices (e.g., through anon-site operator interface), such as during one or more tests andprocedures to ensure proper administration, and/or before and after thetests and procedures to initialize, setup and/or reset the equipment.Likewise, in certain of these embodiments, the on-site operators mayalso (or instead) monitor and control the administration of one or moretests, such as by selecting and/or modifying the questions or outputspresented to the customers based on previous responses from thecustomers and/or test results. In certain other embodiments, some or allof the assistance provided by, and functionality associated with, theon-site operators may be provided by one or more remote operators (e.g.,a technician located at a remote call center or an assistant associatedwith a remote practitioner).

According to certain embodiments, the system (or a portion thereof) maybe configured to enable remote practitioners (e.g., practitioners whoare not at the sites where the customer diagnostic centers are located)to facilitate and assist customers with one or more aspects of thevision examinations, eye-health examinations, and/or other services,features and functionality provided through the customer diagnosticcenters. For example, in certain preferred embodiments, when a customerreceives a vision examination and/or eye health examination through acustomer diagnostic center, various data associated with the customerand one or more of the tests and procedures administered to the customeris provided to a remote practitioner (e.g., via a remote practitionerdevice) to allow the remote practitioner to confirm, evaluate anddiagnose the customer's visual ability and/or eye health and/or create avision and/or eye health report (or similar evaluation) to be providedto the customer.

In certain of these embodiments, this process may occur asynchronously.In other words, after the customer has received the vision examinationand/or eye health examination, the system may deliver the customer dataand customer examination data to the remote practitioner (or make suchdata available to the remote practitioner through a web-based serviceand/or software application installed on the remote practitionerdevice). At some later time, the remote practitioner may then review andanalyze the data, diagnose and confirm various aspects of the customer'svision and eye health, and generate and/or send back customer evaluationdata (e.g., vision report, eye health report, optical prescriptions,etc.), which can then be sent or made accessible to the customer (e.g.,at a customer diagnostic center, at a device associated with thecustomer, etc.).

In certain other embodiments, assistance from remote practitioners mayoccur synchronously. In certain of these embodiments, when a customerrequests a vision examination and/or eye health examination through acustomer diagnostic center (or at some point during the examination orexamination process), the system may be configured to establish areal-time connection to a remote practitioner. As a result, this allowsthe remote practitioner to review and evaluate the customer examinationdata and provide evaluations and reports to the customer in real-time ornear real-time. Additionally, or as an alternative, the remotepractitioner may be able to monitor and control the ophthalmic equipmentand instruments and/or the administration of the tests and procedures tothe customer, in a similar manner to that described above for theon-site (or remote) operator, through the real-time connection with thecustomer diagnostic center.

For example, in certain embodiments, some or all of the ophthalmicequipment and instruments at the customer diagnostic center may beconnected to a personal computer running Windows or any other suitableoperating system and having a client application installed that providesan interface to (e.g., sends commands to and receives data from) theequipment. The client application may be any suitable applicationcapable of providing a remote interface to the ophthalmic equipment,such as the Eyelogic touchscreen-enabled Windows application availablefrom Eyelogic Systems, Inc. In certain embodiments, the clientapplication may store various data (e.g., in a database stored in localmemory at the customer diagnostic center), including data received fromthe ophthalmic equipment and/or customers. In certain of theseembodiments, such as where the personal computer and/or customerdiagnostic center includes various recording devices (e.g., a videorecorder, microphone, etc.) the client application may record and/orstore the vision examination and/or eye health examination session(e.g., the interactions with the customer, tests administered to thecustomer, etc.).

In certain embodiments, the client application and/or personal computermay be connected to a tele-presence system, which may be any suitablesystem for establishing a real-time connection with, and routing orstreaming various data to and from a remote agent (e.g., a remotepractitioner via a remote practitioner device). For example, the clientapplication and/or personal computer may be connected to a tele-presenceclient framework or endpoint, such as the VidyoDesktop softwareapplication available from Vidyo, Inc. The endpoint may connect to atele-presence server and/or server framework, such as a VidyoRouterserver available from Vidyo, Inc, via any suitable network and/ornetwork protocol (e.g., the Internet and/or Session InitiationProtocol). In certain of these embodiments, the tele-presence serverand/or server framework may be integrated with and/or run on one or moreCDC servers or RPM servers included with the eye testing and evaluationsystem (such as CDC servers 20 and 20 a-20 c and/or RPM server 24 shownand described above in connection with FIGS. 1 and 2).

According to certain embodiments, the tele-presence server and/or serverframework may be configured to route the examination and/or examinationsession to an available remote practitioner, such as via a CTS-500Endpoint or other suitable tele-presence client framework or endpointassociated with the remote practitioner (e.g., an endpoint integratedwith or connected to a remote practitioner device). As a result, dataassociated with the examination and/or examination session can bestreamed or otherwise delivered to the remote practitioner in real-time.In certain of these embodiments, the endpoint associated with the remotepractitioner may be configured to send various data back to the endpointassociated with the customer diagnostic center, thereby enabling two-waycommunication between the remote practitioner and the customer. Forexample, the remote practitioner may send back commands for controllingthe ophthalmic equipment and/or the administration of the tests,audio/video data to be output to the customer (e.g., instructions,questions, guidance, etc.) and/or evaluation data pertaining to thecustomer's vision and/or eye health (e.g., vision and/or eye healthreports, prescriptions, recommendations, referrals, etc.).

In certain other embodiments, the tele-presence system may enablereal-time teleconferencing and video conferencing to be establishedwithout the need for specialized networks, endpoints, and/or otherhardware (e.g., dedicated cameras, microphones, monitors, firmware,etc.). For example, the system may utilize a centralizedteleconferencing infrastructure, which enables and manages conferencingbetween software endpoints (e.g., devices having certain softwareinstalled). In certain embodiments, this centralized conferencingarchitecture may be provided and managed by a separate service provided,such as the VidyoRouter service provided by Vidyo, Inc. Importantly, theuse of this type of centralized architecture allows for the conferencingfunctions to be performed at the customer diagnostic centers via thesame hardware (e.g., computer, monitor, etc.) used for controlling theophthalmic equipment, interfacing with the customers, and/oradministering the vision tests and eye examinations. In certain of theseembodiments, the conferencing software that is installed and executed atthe customer diagnostic centers and/or remote practitioner devices maybe customized in any suitable manner, such as to display or presentvarious data to a customer prior to, or during, a conference (e.g.,customer data, prior examination data, introductory videos, logos,etc.).

According to certain embodiments, such as where a real-time conferenceis established between a customer and remote practitioner during theadministration of a vision and/or eye health examination, theexamination and conference (or a portion thereof) may be recorded andstored, such as at the centralized teleconferencing system. In certainof these embodiments, these stored recordings may be accessible to oneor more individuals, such as the customer, remote practitioner, and/orother practitioners. For example, the remote practitioner may wish toreplay some or all of the recorded examination session in connectionwith reviewing and analyzing the customer's examination data and/orproviding a prescription or eye health report. As another example, therecorded examination session may be provided to another practitioner forreview, such as in the case where the customer is referred to aspecialist practitioner for further or follow-up testing, diagnosisand/or treatment.

As shown by the foregoing discussion, the ability for customers who arereceiving vision examinations and/or eye health examinations at acustomer diagnostic center to connect to and interface with remotepractitioners in real-time provides a number of important benefits. Onesuch benefit is that it enables the remote practitioners to “touch andfeel” the customers, such as by interacting with and interrogating thecustomers, thereby allowing the remote practitioners to provide a moremeaningful and accurate evaluation of the customers' vision and eyehealth. Another such benefit is that it allows customers to receivevision examinations and/or eye health examinations in virtually the samemanner as an in-person screening or examination, while significantlyreducing the time, inconvenience and expense associated with visiting apractitioner's office to obtain the in-person screening or examination.

In addition, by utilizing one or more of the systems and methods forimplementing various degrees of automation and/or assistance at thecustomer diagnostic centers, the eye testing and evaluation systemenables a great deal of flexibility and customizability. For example,certain customer diagnostic centers could be configured to providefully-automated vision examinations and/or eye health examinations orexaminations with limited on-site assistance, thereby allowing customersto obtain examinations with little or no assistance and minimizing thecorresponding time and cost required. In certain embodiments, thesefully-automated (or minimally assisted) vision examinations and/or eyehealth examinations could be in the form of limited or partialexaminations (e.g., examinations having a limited set of tests andprocedures that are capable of being automatically processed andevaluated by the system). In turn, some or all of these customerdiagnostic centers (or others) may give customers the option ofreceiving a more extensive or comprehensive vision examination and/oreye health examination (e.g., at a higher cost), such as examinationsthat require the assistance of a remote practitioner.

Vision and Eye Health Evaluations

As mentioned above, in connection with a customer receiving a visionexamination and/or eye health examination through a customer diagnosticcenter, the customer diagnostic center and/or eye testing and evaluationsystem may generate and/or provide the customer with customer evaluationdata pertaining to the customer's vision and/or eye health, such as oneor more reports, charts, documents, summaries, test results,recommendations, referrals, treatments, etc. In certain of theseembodiments, some or all of the customer evaluation data may beautomatically generated by the customer diagnostic center and/or eyetesting and evaluation system, such as by applying various software andalgorithms to, and otherwise processing, the data associated withadministering the tests and procedures to the customer and/or other data(e.g., customer data). Alternatively, or in addition, some or all of thecustomer evaluation data may be received (or be based on data received)from a remote practitioner, such as in response to providing thecustomer examination data and customer data to the remote practitionerfor review and analysis.

In certain embodiments, such as where a customer receives a visionexamination through a customer diagnostic center, the customerevaluation data may include vision evaluation data, such as an opticalprescription, set of optical specifications and/or an order foreyeglasses and/or contact lenses (e.g., FDA Class I, OTC medicaldevices). In certain of these embodiments, such as where the customerevaluation data is received (or based on data received) from a remotepractitioner, the optical prescription (and/or optical specifications ororder) may be signed by the remote practitioner (e.g., using anelectronic signature or similar mechanism) and dated. The opticalprescription may or may not indicate an expiration date and/or mayindicate to the customer that the optical prescription can be filled bythe optical dispenser of the customer's choice.

In certain embodiments, the vision evaluation data may include data andinformation pertaining to one or more parameters associated with thecustomer's visual acuity, such as the parameters used to determine therefractive error of the customer's eyes. For example, the visionevaluation data may include the strengths or curvatures in degreesand/or Diopters (e.g., converted from millimeters of radius of curvatureinto Dioptric strength power) for one or more components of visualacuity, such as (1) Sphere in Diopters (e.g., in connection with simplemyopia/nearsightedness and hyperopia/farsightedness); (2) Cylinder Powerin Diopters (e.g., in connection with astigmatism), (3) Axis of Cylinderin degrees from 0 to 180 (e.g., in connection with astigmatism); and/or(4) another Sphere in Diopters, such as bifocal power pertaining toadditional correction needed for reading (e.g., in connection withpresbyopia, typically present in individuals over 45). In certainembodiments, the vision evaluation data may include information thatindicates the corrected and/or un-corrected visual acuities for thecustomer's eyes, which may include each eye separately, e.g. 20/40 inthe left eye at distance, and/or for the two eyes together. In certainof these embodiments, the vision evaluation data may include anexplanation for such visual acuities (e.g. in order for a person with20/40 vision to see what someone with normal 20/20 vision sees at 40feet distance, the person with 20/40 vision must be 20 feet away fromthe same object).

In addition to (or instead of) the optical prescription, the visionevaluation data may include a vision report that provides informationconcerning any specific vision or refractive disorders or conditionsthat were detected and/or diagnosed through the vision examination. Forexample, the vision report may indicate whether or not the customer hascertain vision disorders or conditions, such as simple myopia; simplehyperopia; mixed compound astigmatism, hyperopic astigmatism, myopicastigmatism, and/or presbyopia. If any such vision disorders orconditions were detected and/or diagnosed, the vision report may includeadditional information pertaining to the disorder, such as a generaldescription, recommended treatment, etc. In certain of theseembodiments, if one or more particular types of disorders or conditionsare detected, the vision report and/or vision evaluation data mayinclude a referral for the customer to visit a practitioner in-person.

According to certain embodiments, such as where a customer receives aneye health examination through a customer diagnostic center, thecustomer evaluation data may include eye health evaluation data. Incertain of these embodiments, the eye health evaluation data may includean eye health report, in a similar manner to the vision report describedabove. For example, the eye health report may include various data andinformation that indicates whether the customer's eyes were found to benormal, healthy and/or functioning properly. In certain of theseembodiments, the eye health report may indicate whether or not thecustomer has certain eye disorders or conditions, such as glaucoma,corneal defects, cataracts, color blindness, etc. and may includeadditional information pertaining to any such disorder or condition thathas been detected and/or diagnosed.

In certain embodiments, when one or more eye disorders or conditionshave been detected and/or diagnosed, the eye health evaluation data mayindicate whether there is a need for the customer to seek furtherevaluation, testing and/or treatment through an in-person consultationwith an eye health practitioner (e.g., an eye surgeon or otherspecialist). In certain embodiments, such as where the customerexamination data is provided to a remote practitioner for review, theneed for further in-person evaluation may be based on determinations orrecommendations received from the remote practitioner. Alternatively, oradditionally, the system may be configured to automatically detectand/or flag certain examination data or results as indicating apotential need for the customer to seek further evaluation (as describedin more detail below). In certain embodiments, the eye health evaluationdata may include referrals for the customer to see one or moreparticular eye health practitioners. In certain of these embodiments,the eye health report may indicate that the referral is urgent and/ormandatory, such as in order to prevent or reduce the risk of permanentvision loss.

According to certain embodiments, the vision evaluation data and/or eyehealth evaluation data may include one or more recommendations for thecustomer pertaining to future vision examinations and/or eye healthexaminations. For example, the vision evaluation data and/or eye healthevaluation data may indicate a recommendation for how often the customershould obtain vision examinations and/or eye health examinations (e.g.,once a year, once every two years, etc.). In certain embodiments, theserecommendations may be based on various customer data (e.g., thecustomer's age, ethnicity, sex, vision/eye health, individual and familymedical history, length of time since the customer's previousexamination), and/or risk profiles and similar information provided byvarious well-known vision and eye health organizations (e.g., theAmerican Academy of Ophthalmology). Likewise, in certain embodiments,the urgency of other recommendations (e.g., referrals to see otherpractitioners) may be determined in a similar manner. In certainembodiments, the vision evaluation data and/or eye health evaluationdata may also include specific diagnoses and/or indicate an actual orsuspected condition of a customer's eyes (e.g., whether a customer hashealthy eyes or is suspected of having an eye disease, abnormality orother condition).

While the foregoing discussion describes certain types of informationthat may be included in the customer evaluation data provided tocustomers who receive vision examinations and/or eye health examinationsthrough the customer diagnostic centers, it should be understood thatthe particular types of information described are intended to beexemplary, not exhaustive, and various other types of information couldeasily be included and/or utilized instead of some or all of theinformation described above. Similarly, although the vision evaluationdata and eye health evaluation data are described separately in thediscussion above, it should be understood that, in certain embodiments,some or all of the data and information associated with the visionevaluation data and eye health evaluation data may be combined orintegrated. For example, in certain embodiments, such as where thecustomer receives both a vision examination and eye health examinationor where the eye health examination incorporates one or more testsassociated with vision examination, the customer evaluation data mayinclude a combined vision/eye health report having some or all of theinformation associated with the vision evaluation data and eye healthevaluation data described above.

In certain embodiments, customers may be able to access the customerevaluation data (or a portion thereof) through the customer diagnosticcenters. In certain of these embodiments, such as where the visionexamination and/or eye health examination is fully automated (or onlyinvolves assistance from an on-site operator) or where a real-timeconnection is established with a remote practitioner, the customerevaluation data may be provided to the customer at the customerdiagnostic center (e.g., displayed on one or more screens) during and/orshortly after the customer receives the vision examination and/or eyehealth examination. Alternatively (or in addition), the customer may beable to access the customer evaluation data by returning to the samecustomer diagnostic center (and/or one or more other customer diagnosticcenters) at a later time. In certain embodiments, the customer may beable to print out some or all of the customer evaluation data (e.g., anoptical prescription or referral) using one or more printers provided atthe customer diagnostic center.

According to certain embodiments, the customer evaluation data (or aportion thereof) may be sent and/or made accessible to the customersthrough various other systems and devices, such as one or more personalcomputing devices associated with the customers. For example, thecustomer evaluation data may be sent via e-mail or any other suitabledelivery mechanism. As another example, customers may be able to accessthe customer evaluation data from a wide range of computing devices,such as by logging into a web-based service or application provided bythe customer diagnostic center and/or eye testing and evaluation systemand/or through a software application (e.g., client application, mobileapp, etc.) installed on the customers' devices. In a similar manner, thecustomers may be able to instruct the customer diagnostic center and/oreye testing and evaluation system to forward some or all of the customerevaluation data to various third parties and/or third party systems,such as an external practitioner, optical lens lab, or third partyprovider of vision and eye care products and/or services. In certain ofthese embodiments, the customer evaluation data may be sent to thecustomer and/or one or more third parties automatically or only inresponse to a request by the customer. In certain embodiments, thecustomer evaluation data may be conveyed to the customer over atelephone. For example, a customer who requests to speak with apractitioner may provide a telephone number to enable the practitionerto call the customer at a convenient time.

Data Analysis for Diagnosis and Risk Prediction

In accordance with certain embodiments, such as those illustrated anddescribed in connection with FIGS. 1-3, the customer diagnostic centersand/or other components of the eye testing and evaluation system (e.g.,CDC servers, database servers, etc.) may store and/or update a widerange of data in connection with providing vision examinations and/oreye health examinations to customers. The eye testing and evaluationsystem may store and/or update various customer data (e.g., backgroundand demographical data, prior vision examination and/or eye examinationresults, individual and family medical history, and othercharacteristics and preferences) associated with the customers.Similarly, the eye testing and evaluation system may store and/or updatecustomer examination data (e.g., customer inputs and responses,instrument measurements, tests and procedures performed, etc.), customerevaluation data (e.g., reports, prescriptions, recommendations,referrals, digital images and other imaging data, etc., generated by thesystem and/or received from remote practitioners) and/or other types ofdata associated with the vision examinations and/or eye healthevaluations provided to customers through the customer diagnosticcenters.

In certain embodiments, the eye testing and evaluation system may storeand/or update testing analytics data associated with reviewing,analyzing and processing the customer examination data and/or customerdata, such as one or more algorithms and formulas (e.g., to calculaterefractive error) and/or various standards, norms, and metrics (e.g.,normal or acceptable ranges for certain parameters) that may be appliedto the measurements or test results and/or otherwise utilized inconnection with detecting or diagnosing various disorders, defects andconditions and evaluating the customers' vision and eye health.Additionally (or alternatively), the eye testing and evaluation systemmay store and/or update risk prediction data pertaining to various riskfactors, risk profiles, correlations and similar information that isassociated with vision and eye related disorders, defects and conditionsthat are more likely to occur in certain groups of individuals.

In certain of these embodiments, the risk prediction data may includerisk factors and the like that are based on a person's background (e.g.,welders are more prone to have corneal scars that can cause irreversibleloss of vision), ethnicity (e.g., Hispanic Americans are more prone by20% to acquire glaucoma, and African Americans are 40% more prone toacquire glaucoma, as compared to Caucasian Americans), income (e.g.,lower income families typically have less frequent eye exams andrefractions, and less primary medical health care, and are more prone toirreversible vision caused by diabetes and hypertension), prior medicalhistory (e.g., individuals with pre-existing hypertension, diabetes, orhistory of eye disease and/or disorders, eye surgeries, etc., are moreprone to certain systemic eye disorders and syndromes, such as syphilis,Bell's Palsy, shingles, etc.), age (e.g., individuals over sixty aremore prone to certain age related eye diseases (AREDS), such ascataracts, glaucoma, diabetic retinopahy, macular degeneration, etc.).

According to certain embodiments, some or all of this data (and variousother data) may be utilized by the eye testing and evaluation system ina number of different ways. In certain embodiments, the eye testing andevaluation system may use this data to determine whether customers havea higher risk for various vision and eye related disorders, defectsand/or conditions. For example, in response to receiving new or updatedcustomer data (and/or other data) from a customer, the customerdiagnostic center and/or eye testing and evaluation system may comparethe customer data to the prediction data to determine whether thecustomer's demographics, characteristics, etc. match any risk profilesor factors in the prediction data. In certain of these embodiments, theeye testing and evaluation system may create and store an individualrisk profile for new customers that includes a list of any high-riskdisorders, defects, and/or conditions identified for the customer (e.g.,prescreen the new customers) and/or update the individual risk profilewhen additional or updated customer data is received.

In turn, the individual risk profile (or similar data) could be includedwith the customer examination data for the customer that is sent to aremote practitioner (e.g., to assist the remote practitioner's reviewand evaluation) and/or used to select, modify and/or tailor tests andprocedures administered to the customer and various recommendationsprovided to the customer. In certain of these embodiments, the eyetesting and evaluation system may use the individual risk profilesand/or other data (e.g., customer data and customer evaluation data) tocreate and update a customized testing plan for a customer. For example,the customized testing plan may include one or more customized visionexaminations and eye health examinations (e.g., specifying a particulargroup of tests and procedures to be administered), a recommendedschedule for receiving such vision examinations and eye healthexaminations, recommended actions, medicines or treatments, and/orreferrals to see one or more eye care practitioners in-person (e.g., ona one-time and/or periodic basis).

In certain embodiments, the eye testing and evaluation system may usesome or all of the stored data described above in connection withevaluating the customer examination data and other data associated withadministering vision examinations and/or eye health examinations tocustomers through the customer diagnostic centers. For example, the eyetesting and evaluation system may process and analyze the customerexamination data based on the testing analytics data, such as toautomatically calculate various parameters using predefined formulasand/or detect and diagnose certain disorders, defects and conditions bycomparing the customer examination data to one or more standards (e.g.,normal or acceptable ranges or results). In certain embodiments, thesystem may utilize software to analyze images or other digital scanningdata to diagnosis and/or risk prevention purposes. For example, imagesor scanning data associated with the ganglion cell layer may be analyzedby the software for detecting or preventing chronic glaucoma. In certainof these embodiments, such as where the customer examination data issent to remote practitioners, the eye testing and evaluation system mayinstead (or in addition) use the testing analytics data to pre-processand package the customer examination data before providing it to theremote practitioner. For example, in connection with measuring orcalculating a particular parameter (e.g., intraocular pressure) the eyetesting and evaluation system may create a chart or graph that shows theparameter for the customer in relation to an acceptable range associatedwith the parameter. Importantly, pre-processing and packaging thecustomer examination data that is provided to remote practitioners makesit easier and more efficient for remote practitioners to review the dataand/or confirm the results, thereby reducing the time associated withevaluating and providing reports to each customer.

In certain embodiments, the eye testing and evaluation system may usesome or all of the stored data described above to track and evaluate thecustomers' vision and/or eye health over time. For example, when acustomer receives a vision examination and/or eye health examinationthrough a customer diagnostic center, the examination data and/orevaluation data may be compared with data for previous visionexaminations, eye health examinations and other similar tests receivedby the customer (e.g., data associated with previous tests receivedthrough a customer diagnostic center, from an external practitioner, ora combination thereof). In certain of these embodiments, the eye testingand evaluation system may generate and/or update various charts, graphs,images, summaries, etc. using the current and previous examinationand/or evaluation data, such as to show the progression of one or moreparameters, defects, disorders, and/or conditions. For example, after acustomer receives a vision examination, the eye testing and evaluationsystem may create or update a chart that illustrates the changes in therefractive error of the customer's eyes over a specified period. Incertain embodiments, these charts, graphs, and/or other tracking dataassociated with the progression of the customer's vision and/or eyehealth may be included with the customer examination data that is sentto the remote practitioners in order to assist the remote practitionersin making an informed evaluation and diagnosis.

In turn, by keeping track of customers' vision and/or eye health overtime, the eye testing and evaluation system can determine whether atreatment previously prescribed to the customer is working (e.g.,whether there has been any improvement or change in a defect orcondition being treated), and/or evaluate the outcome of a surgery,operation or procedure previously performed on the customer. Similarly,the eye testing and evaluation system may use the tracking data inconnection with detecting and/or diagnosing certain disorders, defectsand/or conditions and/or determining whether a customer should bereferred to one or more external eye care practitioners. For example, ifthe eye testing and evaluation system detects that a customer's visualacuity is worsening or not improving despite the use of refractivelenses, this may be a strong indication that the customer has a medicalanomaly, disorder or disease (e.g., optic nerve inflammation orinfection, amblyopia, cataracts, etc.) and the system may refer thecustomer to an eye-care practitioner or specialist (e.g., a cataractspecialist).

According to certain embodiments, the eye testing and evaluation systemmay use some or all of the stored data described above to tweak ormodify certain existing risk factors, risk profiles, standards,correlations etc. and/or identify new risk factors. For example, the eyetesting and evaluation system may analyze the customer data, customerexamination data and/or customer evaluation data to search for potentialcorrelations between various parameters (e.g., female Asian Americanshave a 30% higher risk of developing cataracts). Similarly, the eyetesting and evaluation system may analyze this data to confirm theaccuracy of existing risk factors and correlations and/or variousstandards and norms (e.g., normal ranges for parameters). In turn, ascustomer data and examination and evaluation data is continuouslycollected, compiled and processed by the system, these risk factors,correlations and/or standards can be periodically updated to reflect thedata.

Exemplary Method for Providing an Eye Testing and Evaluation Service

FIG. 6 is a flow chart illustrating an exemplary method 600 foradministering an eye testing and evaluation service in accordance withcertain embodiments of the present invention. Initially, one or moretests associated with an eye health examination and/or visionexamination are provided to a customer (step 610). In certainembodiments, the one or more tests may be administered at a customerdiagnostic center. Next, customer examination data relating to the eyehealth examination and/or vision examination is generated (step 620).The customer examination data may include any data associated with thecustomer and any data that enables or assists a remote practitioner toevaluate the customer's eye health and visual ability, detect anddiagnose certain disorders, defects and conditions and/or confirm thatone or more of the tests and procedures were administered correctly. Incertain embodiments, the customer examination data may include dataassociated with the customer (e.g., the customer's name, age, gender,race, medical history, prior test results, etc.) and data associatedwith one or more of the tests administered to the customer (e.g.,responses, inputs and selections from the customer, instrumentmeasurements and readings, test results, etc.). In certain embodiments,the customer examination data may include a live video stream or videorecording of the eye health examination and/or vision examination thatwas provided to a customer.

The customer examination data is transmitted over a computer network(e.g., the Internet) from a customer diagnostic center to a diagnosticcenter server (step 630). The diagnostic center server may store all ora portion of the customer examination data. The diagnostic center serverprovides access to one or more practitioner devices to enable apractitioner device to access the customer examination data (step 640).This permits a practitioner operating a practitioner device to reviewthe customer examination data from a location that is located remotelyfrom the customer diagnostic center where the one or more tests areadministered to the customer. In certain embodiments, a practitioner mayaccess the customer examination data in real-time as tests are beingadministered to the customer. In certain embodiments, a practitioner mayaccess the customer examination data after the tests are administered tothe customer.

After or while the practitioner is reviewing the customer examinationdata, customer evaluation data is generated that pertains to theeye-care practitioner's review and evaluation of the customerexamination data (step 650). The customer evaluation data received fromthe remote practitioner may include various reports, diagnoses,recommendations and other information indicating the results of the eyehealth and vision tests and procedures administered to the customer. Incertain embodiments, the customer evaluation data may include an eyehealth report or may be used to generate an eye health report. The eyehealth report may include a summary of the customer's eye health, visualacuity, test results and procedures, diagnoses, optical prescriptions,pharmaceutical prescriptions, recommendations, treatment instructions,referrals to see other eye care professionals, and/or other data that isassociated with the customer, practitioner or the customer's visit tothe customer diagnostic center. The eye health report which is based, atleast in part, on the customer evaluation data is then provided to thecustomer through the network (step 660). The eye health report may beprovided to a customer in various ways. In certain embodiments, the eyehealth report may be presented to the customer through the diagnosticcenter 10. In certain embodiments, the customer may be permitted toaccess the eye health report using one or more computing devicesassociated with the customer. In certain embodiments, the customer maybe permitted to download a copy of the eye health report from a websiteafter logging in (e.g., with a username and password) to an account onthe website. In certain embodiments, the eye health report may betransmitted to the customer via electronic mail.

Exemplary Methods for Providing Vision and Eye Health Examinations

FIG. 7 is a flow chart illustrating an exemplary method 700 foradministering a synchronous vision examination in accordance withcertain embodiments of the present invention. Initially, a connection isestablished between a customer diagnostic center 10 and a remotepractitioner device 30 (step 710). In certain embodiments, a request maybe transmitted to a server from the customer diagnostic center forestablishing the connection and the request may be accepted by theremote practitioner device 30. A remote practitioner associated with theremote practitioner device 30 may be selected by the server or anindividual at the customer diagnostic center 10 and the remotepractitioner may choose whether or not to accept the request. In certainembodiments, the connection may be established through the server (e.g.,customer diagnostic center server 20, remote practitioner managementserver 24 or other server) or made directly between the customerdiagnostic center 10 and the remote practitioner device 30. In certainembodiments, the connection may provide a live audio/video stream toboth the remote practitioner device 30 and the customer diagnosticcenter 10 in order to facilitate communication between a remotepractitioner who is operating the remote practitioner device 30 and acustomer and/or on-site personnel located at the customer diagnosticcenter 10. Any data transmitted via the connection may be encrypted forsecurity purposes.

Next, a preliminary refractive error is determined for the customerlocated at the customer diagnostic center 10 (step 720). The preliminaryrefractive error may be determined by analyzing prior prescriptions,analyzing data associated with prior vision examinations, retrievingcustomer data that is stored in a database or a tangible record,utilizing a lensometer 144, or by other means.

After a preliminary refractive error is determined for the customer, aninteractive refraction test may be administered to the customer in amanner that permits the remote practitioner to monitor and control thevision examination (step 730). In certain embodiments, the remotepractitioner may be presented with an interface on the remotepractitioner device 30 that permits the practitioner to control theequipment (e.g., turn the equipment on/off, move the equipment, takemeasurements, etc.). For example, by selecting interface elements (e.g.,buttons, links or on-screen controls) on the interfaces, thepractitioner may cause the remote practitioner device 30 to transmitcommands to the equipment controller 130 located at the customerdiagnostic center 10, thus permitting the practitioner to operate andmanipulate the equipment. The remote practitioner may be permitted tocontrol any equipment that is relevant to providing a vision examinationincluding, but not limited to, an auto phoropter 141, lens houser 142,auto-refractor 143, lensometer 144 and eye chart 145 (and any projectorassociated with an eye chart). In certain embodiments, the remotepractitioner may not be able to directly control the equipment. Rather,personnel at the diagnostic center 10 may control the equipment and theremote practitioner may provide instructions to the personnel via theestablished connection.

After or while the vision examination is administered, examination dataassociated with the vision examination (including examination data thatindicates an updated refractive error for the customer) may betransmitted to the remote practitioner device 30 for review by theremote practitioner (step 740). In response, the customer may receiveevaluation data and/or an eye health report from the remote practitioner(step 750). In certain embodiments, the evaluation data and/or an eyehealth report may be transmitted to the customer diagnostic center 10from the remote practitioner device 30 while the customer is present atthe customer diagnostic center 10. In certain embodiments, theevaluation data and/or an eye health report may be transmitted to thecustomer after the customer leaves the customer diagnostic center 10(e.g., via e-mail, traditional mail service, or through a website).

FIG. 8 is a flow chart illustrating an exemplary method 800 foradministering an asynchronous vision examination in accordance withcertain embodiments of the present invention. A preliminary refractiveerror may initially be determined for a customer located at a customerdiagnostic center 10 (step 810). The preliminary refractive error may bedetermined in the same ways discussed above. In certain embodiments,this step may be performed by technicians, operators, or other personnellocated at the customer diagnostic center 10. In certain embodiments,this step may be performed by the customer (e.g., by permitting thecustomer to specify preliminary refractive error results from priorexaminations). Next, a refraction test may be administered to thecustomer at the customer diagnostic center 10 (step 820) and an updatedrefractive error may be determined for the customer (step 830). Onceagain, these steps may be performed by technicians, operators, or otherpersonnel located at the customer diagnostic center 10. In certainembodiments, the step of determining an updated refractive error may beperformed at a subsequent time by a remote practitioner after reviewingthe examination data associated with the vision examination.

After the refraction test is administered to the customer (and possiblyafter an updated refractive error has been determined), examination dataassociated with the vision examination is transmitted to a server forstorage (step 840). The server may represent a customer diagnosticcenter server 20, remote practitioner management server 24 or otherserver. In certain embodiments, the vision examination system may beprovided, at least in part, by a cloud-based service and the server maybe associated with the cloud-based service. In certain embodiments, thestored examination data may be associated with a particular remotepractitioner (e.g., which may be selected by a round robin process orwho may be a practitioner who has serviced the customer in the past).One or more remote practitioners may be provided with access to thestored examination data located on the server (step 850). In certainembodiments, the remote practitioners may receive and accept a requestfor providing the asynchronous vision examination for the customer. Theremote practitioners may be selected by an individual at the customerdiagnostic center or by the server. In certain embodiments, the remotepractitioner may enter login credentials (e.g., username and password)to access the stored examination data associated with the customer.After reviewing the examination data, the remote practitioner mayprovide evaluation data and/or eye health report to the customer (step860). Once again, the evaluation data and/or an eye health report may betransmitted to the customer after the customer leaves the customerdiagnostic center 10.

FIG. 9 is a flow chart illustrating an exemplary method 900 foradministering a synchronous eye health examination in accordance withcertain embodiments of the present invention. A connection may beestablished between a customer diagnostic center 10 and a remotepractitioner device 30 prior to administering an eye health examination(step 910). In certain embodiments, a request may be transmitted to aserver from the customer diagnostic center for establishing theconnection and the request may be accepted by the remote practitionerdevice 30. A remote practitioner associated with the remote practitionerdevice 30 may be selected by the server or an individual at the customerdiagnostic center 10 and the remote practitioner may choose whether ornot to accept the request. In certain embodiments, the connection may beestablished through a server (e.g., customer diagnostic center server20, remote practitioner management server 24 or other server) orestablished directly between the customer diagnostic center 10 and theremote practitioner device 30. Once again, the connection may provide alive audio/video stream to both the remote practitioner device 30 andthe customer diagnostic center 10 in order to facilitate communicationbetween a remote practitioner who is operating the remote practitionerdevice 30 and a customer and/or on-site personnel located at thecustomer diagnostic center 10. Any data transmitted via the connectionmay be encrypted for security purposes.

A remote practitioner may be permitted to control one or more ophthalmicdevices located at the customer diagnostic center 10 for conducting theeye health examination (step 920). As explained above, the remotepractitioner may be presented with an interface on the remotepractitioner device 30 that permits the practitioner to control andmanipulate the equipment by selecting interface elements or in otherways. The remote practitioner may be permitted to control any equipmentthat is relevant to providing an eye health examination including, butnot limited to, a digital imager 151, bio-microscope 152, retinal camera153, tonometer 154 and visual field instruments 155. The remotepractitioner may then administer the eye health examination to thecustomer located at the customer diagnostic center 10 as the remotepractitioner monitors the eye health examination in real-time (step930).

After or while the eye health examination is administered to thecustomer, examination data associated with the eye health examinationmay be transmitted to the remote practitioner device 30 (step 940). Incertain embodiments, the examination data may initially be transmittedto a server (e.g., customer diagnostic center server 20, remotepractitioner management server 24 or other server) which may thenprovide the examination data to the practitioner device 30 or make theexamination data available to the practitioner device 30. After theremote practitioner has reviewed the examination data, the customer maythen receive evaluation data and/or eye health report from the remotepractitioner (step 950). As mentioned above, the evaluation data and/oreye health report may be provided to the customer while the customer isat the customer diagnostic center 10 or afterwards by other means.

FIG. 10 is a flow chart illustrating an exemplary method 1000 foradministering an asynchronous eye health examination in accordance withcertain embodiments of the present invention. Initially, ophthalmicequipment is utilized to generate examination data associated with aneye health examination for a customer at a customer diagnostic center(step 1010). The examination data may include data generated byophthalmic equipment or any other data associated with the eye healthexamination. This step may be performed by technicians, operators, orother personnel located at the customer diagnostic center 10. After orwhile the examination data is generated, the examination data may betransmitted to a server (step 1020) and stored on the server (step1030). As mentioned above, the server may represent a customerdiagnostic center server 20, remote practitioner management server 24,server associated with a cloud-based service or other server. In certainembodiments, the stored examination data may be associated with one ormore remote practitioners. For example, a remote practitioner may berandomly selected to review the examination data (e.g., by selecting thepractitioner using a round robin process or in other ways) or may beselected to review the examination data because the practitionerpreviously serviced the customer in the past (e.g., previouslyadministered a vision or eye health examination to the customer).

One or more remote practitioners may be provided with access to thestored examination data located on the server (step 1040). In certainembodiments, the remote practitioners may receive and accept a requestfor providing the examination for the customer. The remote practitionersmay be selected by an individual at the customer diagnostic center or bythe server. In certain embodiments, the remote practitioner may enterlogin credentials (e.g., username and password) to access the storedexamination data associated with the customer. After reviewing theexamination data, the remote practitioner may provide evaluation dataand/or eye health report to the customer (step 1050). As mentionedabove, the evaluation data and/or an eye health report may be providedto the customer while the customer is at the customer diagnostic center10 or afterwards by other means.

It should be recognized that the above methods are merely meantdemonstrate how vision and eye health examinations can be administeredto customers and are not meant to be limiting. Numerous variations canbe made to the methods without departing from the scope of the presentinvention.

Extended Services and Functionality

In certain embodiments, customers may be able to view, compare, orderand/or purchase various vision and/or eye care related products andservices through the customer diagnostic centers and/or the eye testingand evaluation system. For example, the customer diagnostic centersand/or the eye testing and evaluation system may store and/or accessvarious information associated with products (e.g., eyeglasses, contactlenses, etc.) that are offered by one or more third parties. As aresult, customers may be able access, view and/or browse through theseproducts at the customer diagnostic centers (e.g., through a displayscreen included with the customer interface). Customers may also, orinstead, be able to access the products from other devices (e.g., acomputing device associated with the customer), such as through aweb-based service or client application installed on the customer'sdevice.

In certain embodiments, the customer diagnostic centers and/or the eyetesting and evaluation system may display a virtual representation orsimulation of the customer wearing or using a particular product inorder to illustrate how certain products would look on the customer. Forexample, the customer may be able to view a virtual representation ofhis or her face and/or head, and select one or more eyeglasses to beshown with the virtual representation. In certain of these embodiments,the virtual representation of the customer may be based on data obtainedthrough one or more tests associated with the vision examinations and/oreye health examinations (e.g., via digital imaging devices, videocameras, etc.).

According to certain embodiments, the customer diagnostic centers and/orthe eye testing and evaluation system may be configured to recommend oneor more vision and/or eye care related products and services to thecustomers. For example, the eye testing and evaluation system may selectone or more products to recommend to a customer based on various dataassociated with the customer, such as customer data (e.g., income, sex,age, prior products purchased, etc.) and/or customer examination andevaluation data (e.g., refractive error, optical specifications,astigmatism, etc.). Similarly, the eye testing and evaluation system maydetermine product recommendations for a customer based on dataassociated with various other customers, such as by identifying productspurchased by customers with similar characteristics, backgrounds,disorders, etc. In certain other embodiments, the productrecommendations may be based on a “preferred” status associated with oneor more third party vendors (e.g., vendors who pay a fee to emphasizetheir products and services).

In certain embodiments, after a customer has browsed through andselected one or more products and services, the customer may be able toorder and/or purchase the selected products and services through thecustomer diagnostic center. In certain of these embodiments, thecustomer diagnostic center and/or eye testing and evaluation system mayforward various data to the third party associated with the purchasedproducts and services, such as order data, customer data, and/orcustomer evaluation data (e.g., optical specifications).

In certain embodiments, various advertisements and/or promotionalmaterials (e.g., coupons, offers, discounts, etc.) may be presented orprovided to customers through the customer diagnostic centers. Incertain of these embodiments, for example, advertisements and promotionsmay be displayed to customers (e.g., through one or more displaysincluded with the customer interface) before, during, and/or after thecustomer receives a vision examination and/or eye health examinationthrough the customer diagnostic center. In certain embodiments, theadvertising and promotional materials may include materials that areassociated with various vision and eye care related products andservices, and/or may include materials for a wide range of otherconsumer products and services. In certain embodiments, such as wherethe customer diagnostic center includes a printing device, the customersmay be able to print out a hard copy of one or more promotions, such ascoupons. Alternatively, or in addition, customers may be able to selectan option to forward the advertisement or promotion to themselves (e.g.,via e-mail or text).

Importantly, the incorporation of advertising and promotional materialsand other similar services (e.g., allowing vendors to pay for preferredstatus) provides certain benefits to customers. One such benefit isthat, given the revenue generated through such mechanisms, customers maybe able to receive vision examinations and/or eye health examination ata significantly reduced cost, or may even be able to receive certainservices at no charge, thereby encouraging customers to receive suchexaminations on a regular basis.

In certain embodiments, the eye testing and evaluation system may beconfigured to send various notifications and messages to customers(e.g., through email, text, and/or via one or more computing devicesassociated with the customers). For example, in certain embodiments, theeye testing and evaluation system may send a message to a customer toremind the customer that it is time to receive a vision examinationand/or eye health examination, or to remind the customer about anupcoming appointment with an external practitioner (e.g., in connectionwith a previous referral for in-person evaluation). Similarly, the eyetesting and evaluation system may send messages to a customer requestingconfirmation that the customer has made an appointment with and/orvisited an external practitioner (e.g., in the case where a referral forurgent follow-up testing was provided to the customer).

It is understood that the various systems, devices, and methodsdescribed in connection with the foregoing figures are exemplary, andany other suitable systems, devices or methods may be used. Theforegoing is merely illustrative of the principles of this invention andvarious modifications can be made by those skilled in the art withoutdeparting from the scope and spirit of the invention. As an example,although certain embodiments of the eye testing and evaluation systemhave been described in connection with a particular number of customerdiagnostic centers and/or remote practitioner devices having certainformats or types, the platform may include any number, format and typeof customer diagnostic centers and/or remote practitioner devices. Asanother example, while the customer diagnostic centers have beendescribed as having certain exemplary ophthalmic equipment andinstruments, the customer diagnostic centers may utilize virtually anysuitable type of such devices and instruments. One skilled in the artwill appreciate that the present invention can be practiced in otherthan the described embodiments, which are presented for purposes ofillustration and not limitation.

What is claimed is:
 1. A system for providing remotely assisted eyeexaminations, comprising: a diagnostic center including ophthalmicequipment comprising a set of instruments that are utilized inadministering an eye examination, wherein at least a portion of theophthalmic equipment is coupled to an equipment controller that isconfigured to receive commands over a network to enable remote controlof the ophthalmic equipment, the ophthalmic equipment located at thediagnostic centers at least including an auto-phoropter; a first remotedevice operated by a first remote individual; and a second remote deviceoperated by a second remote individual; wherein administering the eyeexamination includes: administering, by an on-site individual located atthe diagnostic center, a first set of tests to a customer using theophthalmic equipment located at the diagnostic center, wherein the firstset of tests are utilized to derive one or more objective measurements;generating a first portion of customer examination data based on thefirst set of tests; establishing a first connection between thediagnostic center and the first remote device over a network, whereinthe first connection enables the first remote individual to transmitcommands over the network to remotely control the auto-phoropter andprovides real-time video conferencing between the first remoteindividual and the customer; administering, by the first remoteindividual, a second set of tests to a customer located at the customerdiagnostic center, wherein administering the second set of testsincludes: conducting, over the first connection with the assistance ofthe first remote individual, a subjective refraction portion of the eyeexamination that involves outputting one or more questions to thecustomer and receiving one or more responses from the customer, whereinthe subjective refraction portion of the eye examination is administeredusing an iterative process that includes: presenting, via the firstconnection, questions to the customer based, at least in part, ontesting data comprising the one or more objective measurements and theone or more responses that are received from the customer; based, atleast in part, on the one or more responses received from the customervia the first connection, remotely adjusting the ophthalmic equipmentaccording to selections received via an equipment controller interfacepresented on the first remote device; and determining that the iterativeprocess should be concluded in response to establishing that the one ormore responses received from the customer satisfy one or more conditionsindicating that sufficient data has been collected; generating a secondportion of customer examination data based on the second set of tests;establishing a second connection between the diagnostic center and thesecond remote device over the network, wherein the second connectionprovides real-time video conferencing between the second remoteindividual and the customer; transmitting, to the second remote device,the first portion of customer examination data associated with the firstset of tests and the second portion of customer examination dataassociated with the second set of tests; and receiving, at thediagnostic center, evaluation data over the network based, at least inpart, on an analysis of the first portion of customer examination dataand the second portion of customer examination data by the second remoteindividual.
 2. The system of claim 1, wherein: the ophthalmic equipmentat the diagnostic center includes an eye chart; the equipment controlleris coupled to the eye chart; and the commands transmitted by the firstremote device are received by the equipment controller via the firstconnection and the commands enable the eye chart to be controlledremotely by the first remote individual.
 3. The system of claim 1,wherein: the ophthalmic equipment at the diagnostic center includes: (i)a tonometer that is configured to measure the customers' eye pressure;and (ii) a fundus or retinal camera that is configured to capturedigital images the customers' eyes; the tonometer and the fundus orretinal camera are utilized to administer the first set of tests; andthe first portion of customer examination data includes data comprisestest results associated with the using the tonometer and the fundus orretinal camera.
 4. The system of claim 1, wherein: the auto-phoropterincludes a plurality of lenses; the commands transmitted over thenetwork via the first connection enable the first remote individual toremotely switch the lenses that are presented to the customer during theeye examination; the second connection enables the second remoteindividual to remotely control the auto-phoropter; and a second set ofcommands are transmitted over the network via the second connection toenable the second remote individual to remotely switch the lenses thatare presented to the customer during the eye examination.
 5. The systemof claim 1, wherein the eye examination is a comprehensive eyeexamination and includes: (a) objective and subjective refraction teststo assess the customer's visual acuity; and (b) eye health tests tocheck for disorders, diseases or other negative health conditionsassociated with the customer's eyes.
 6. The system of claim 1, wherein:the on-site individual is an operator, technician, assistant or otherindividual who is located at the diagnostic center to provide assistanceto the customer; the first remote individual is an eye doctor,optometrist, ophthalmologist, practitioner, technician, or otherindividual who is capable of administering or monitoring eye tests; andthe second remote individual is an eye doctor, optometrist,ophthalmologist, practitioner, technician, or other individual who iscapable of administering or monitoring eye tests.
 7. The system of claim1, wherein: the evaluation data received at the diagnostic centerincludes a prescription; and the diagnostic center includes at least oneprinter for printing the prescription.
 8. The system of claim 1,wherein: the evaluation data includes a referral for the customer tovisit a practitioner, doctor, or specialist for further evaluation; andthe evaluation data is updated to include the referral in response toone or more disorders or one or more conditions being detected.
 9. Thesystem of claim 1, wherein the first portion of customer examination orthe second portion of customer examination is pre-processed before beingtransmitted to the second remote individual, and pre-processing thefirst portion of customer examination or the second portion of customerexamination includes comparing one or more parameters included in thefirst portion of customer examination or the second portion of customerexamination to one or more standards associated with acceptable testresults.
 10. The system of claim 9, wherein pre-processing the firstportion of customer examination or the second portion of customerexamination further includes generating data for display on the secondremote device that shows the one or more parameters in relation toacceptable ranges to assist the second remote individual with reviewingthe customer's test results.
 11. A method for providing a remotelyassisted eye examination, comprising: administering an eye examinationto a customer at a diagnostic center including ophthalmic equipmentcomprising a set of instruments, wherein at least a portion of theophthalmic equipment is coupled to an equipment controller that isconfigured to receive commands over a network to enable remote controlof the ophthalmic equipment, the ophthalmic equipment located at thediagnostic centers at least including an auto-phoropter; whereinadministering the eye examination includes: administering, by an on-siteindividual located at the diagnostic center, a first set of tests to acustomer using the ophthalmic equipment located at the diagnosticcenter, wherein the first set of tests are utilized to derive one ormore objective measurements; generating a first portion of customerexamination data based on the first set of tests; establishing a firstconnection between the diagnostic center and a first remote device overa network, wherein the first connection enables a first remoteindividual to transmit commands over the network to remotely control theauto-phoropter and provides real-time video conferencing between thefirst remote individual and the customer; administering, by the firstremote individual, a second set of tests to a customer located at thecustomer diagnostic center, wherein administering the second set oftests includes: conducting, over the first connection with theassistance of the first remote individual, a subjective refractionportion of the eye examination that involves outputting one or morequestions to the customer and receiving one or more responses from thecustomer, wherein the subjective refraction portion of the eyeexamination is administered using an iterative process that includes:presenting, via the first connection, questions to the customer based,at least in part, on testing data comprising the one or more objectivemeasurements and the one or more responses that are received from thecustomer; based, at least in part, on the one or more responses receivedfrom the customer via the first connection, remotely adjusting theophthalmic equipment according to selections received via an equipmentcontroller interface presented on the first remote device; anddetermining that the iterative process should be concluded in responseto establishing that the one or more responses received from thecustomer satisfy one or more conditions indicating that sufficient datahas been collected; generating a second portion of customer examinationdata based on the second set of tests; establishing a second connectionbetween the diagnostic center and a second remote device over thenetwork, wherein the second connection provides real-time videoconferencing between a second remote individual and the customer;transmitting, to the second remote device, the first portion of customerexamination data associated with the first set of tests and the secondportion of customer examination data associated with the second set oftests; and receiving, at the diagnostic center, evaluation data over thenetwork based, at least in part, on an analysis of the first portion ofcustomer examination data and the second portion of customer examinationdata by the second remote individual.
 12. The method of claim 11,wherein: the ophthalmic equipment at the diagnostic center includes aneye chart; the equipment controller is coupled to the eye chart; and thecommands transmitted by the first remote device are received by theequipment controller via the first connection and the commands enablethe eye chart to be controlled remotely by the first remote individual.13. The method of claim 11, wherein: the ophthalmic equipment at thediagnostic center includes: (i) a tonometer that is configured tomeasure the customers' eye pressure; and (ii) a fundus or retinal camerathat is configured to capture digital images the customers' eyes; thetonometer and the fundus or retinal camera are utilized to administerthe first set of tests; and the first portion of customer examinationdata includes data comprises test results associated with the using thetonometer and the fundus or retinal camera.
 14. The method of claim 11,wherein: the auto-phoropter includes a plurality of lenses; the commandstransmitted over the network via the first connection enable the firstremote individual to remotely switch the lenses that are presented tothe customer during the eye examination; the second connection enablesthe second remote individual to remotely control the auto-phoropter; anda second set of commands are transmitted over the network via the secondconnection to enable the second remote individual to remotely switch thelenses that are presented to the customer during the eye examination.15. The method of claim 11, wherein the eye examination is acomprehensive eye examination and includes: (a) objective and subjectiverefraction tests to assess the customer's visual acuity; and (b) eyehealth tests to check for disorders, diseases or other negative healthconditions associated with the customer's eyes.
 16. The method of claim11, wherein: the on-site individual is an operator, technician,assistant or other individual who is located at the diagnostic center toprovide assistance to the customer; the first remote individual is aneye doctor, optometrist, ophthalmologist, practitioner, technician, orother individual who is capable of administering or monitoring eyetests; and the second remote individual is an eye doctor, optometrist,ophthalmologist, practitioner, technician, or other individual who iscapable of administering or monitoring eye tests.
 17. The method ofclaim 11, wherein: the evaluation data received at the diagnostic centerincludes a prescription; and the diagnostic center includes at least oneprinter for printing the prescription.
 18. The method of claim 11,wherein: the evaluation data includes a referral for the customer tovisit a practitioner, doctor, or specialist for further evaluation; andthe evaluation data is updated to include the referral in response toone or more disorders or one or more conditions being detected.
 19. Themethod of claim 11, wherein the first portion of customer examination orthe second portion of customer examination is pre-processed before beingtransmitted to the second remote individual, and pre-processing thefirst portion of customer examination or the second portion of customerexamination includes comparing one or more parameters included in thefirst portion of customer examination or the second portion of customerexamination to one or more standards associated with acceptable testresults.
 20. The method of claim 19, wherein pre-processing the firstportion of customer examination or the second portion of customerexamination further includes generating data for display on the secondremote device that shows the one or more parameters in relation toacceptable ranges to assist the second remote individual with reviewingthe customer's test results.